Coupons!

Here I am going to provide a list of websites for obtaining coupons or discounts for type 2 diabetes medications. There are so many coupons out there, but I am choosing to publish only ones that I find through the actual drug manufacturers. This way I can be sure that the links I provide to you are only for legitimate coupons. Remember, each program might have some restrictions (you can't be on Medicaid or Medicare for some coupons, some only provide the first month of treatment, etc) so be sure to read into these.

If I've missed a medication that you'd like me to add, please let me know by email or comment. I've focused on the brand name medications here, because most generics don't have manufacturer's coupons, but if you would like to know about any specific generics, I can look into them for you. This is not an all-inclusive list - check with your local pharmacy to see if they have any coupons on hand. Many times drug reps like to leave us with manufacturers coupons for their products and we are more than happy to provide them to patients.

I should mention that Phil and I, in no way, receive any compensation or "perks" from any of the manufacturers for referencing these discount programs and coupons on our blog. These are merely here for your benefit and because we want to see you thriving with diabetes.

Avandia/Avandaryl/Avandamet: Bridges to Access

Bydureon: Amylin Reimbursement Program

Byetta: Amylin Reimbursement Program

Janumet: Merck Patient Assistance Program

Januvia: Special Offers from Merck

Lantus: Lantus Savings Program

Levemir: Levemir FlexPen Savings ; Novo Nordodisk Diabetes Patient Assistance Program

Novolog: Novo Nordodisk Diabetes Patient Assistance Program

Onglyza: Onglyza Savings Program

Prandin/Prandimet: Novo Nordodisk Diabetes Patient Assistance Program

Symlin: Amylin Reimbursement Program

Victoza: Novo Nordodisk Diabetes Patient Assistance Program

Good luck, and God bless!

Dr K., your virtual pharmacist.

As a disclaimer, I am your "virtual" pharmacist, here to provide you with information and answers to questions. However, I am not your local pharmacist and could, in no way, be aware of your specific medical needs. Remember to always check with your medical provider and pharmacist before stopping or starting any new medications. My posts are based on general pharmacy principles and should not considered as your "first opinion" when it comes to your health. Please consult with your doctor and pharmacist about anything regarding your health.

What is a Diabetec?

During the last few days I have noticed questions coming in about what defines being a diabetic and thought I should take a moment and provide a definition.  Keep in mind that this is not my definition, but based on the definition provided by the Center for Disease Control (CDC)

Also, I offer my apology. I probably should have started with this.

The CDC describes diabetes as:

Diabetes is the condition in which the body does not properly process food for use as energy.  Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugars to build up in your blood. This is why many people refer to diabetes as “sugar.”

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

That's a good description of diabetes, but to make it even more simple when you have diabetes there is too much glucose (sugar) in your blood.  That, folks, can lead to some serious problems if left untreated. You can read the complete article here.

The amount of sugar in your blood is measured through an A1c test which measures the average amount of glucose in your blood over the last approximately three months.  If you are interested, take a look at what the ADA has written about A1c tests.

What do those readings mean?  Well, normal (for those who do not have diabetes) is between 4.5 and 6.0.  Prediabetes is defined as having an A1c between 5.7 and 6.4.  If you test 6.5, or higher, on two tests, you probably have diabetes.  Just so you know I am not making this up,  take a look at what the Mayo Clinic writes about A1c test results.

To put this in perspective, when I was diagnosed with diabetes, I had an A1c of 13 - kind of high.  Okay, very high and in every 'red' zone I have ever seen.  Three years later my A1c results are routinely between 5.9 and 6.1.  So, I know diabetes can be fought and controlled first hand.  And, I know you can do it.

So, if your A1c test results are between 5.7 and 6.4, you are probably being told by your doctor you have prediabetes, so take action and beat it!  Beat it before you are told you have diabetes.  If above 6.5, your doctor is probably telling you that you are a diabetic - now, you really have to take action.

What action do you take? Change your diet. Take your meds. Exercise 30 minutes a day.

You can beat diabetes.  You can control and manage it.  Do not let diabetes manage you!

As always, thank you for reading.  I wish the very best life for you.

A Test You Can't Fail - Part Three - How to Test

During the last few days I have been reading instructions on various sites about how to test using a glucose meter.  Most of them are pretty good and get the high points really well.  However, there are a few things they miss, which can make all of the difference in the world when testing.  So, here is the process I follow for testing.

When do I test? I test when I first get up in the morning before I eat or drink anything except water, and then at night before going to bed.

The steps I always follow are:

1. I wash my hands carefully using plain soap; soap without any fragrance.  I found scented soaps would effect my readings - make them higher.  The last thing I ever need is a fasle higher reading.
2. Dry your hands using either a clean hand towel or paper towels.  I use paper towels because I know they are not putting anything on my fingers.  If you paper towels are scented, do not use them.  (Heck, I don't even know if scented paper towels are made, but I thought I'd hammer the un-scented thing one more time.)
3. Give the hand you are going to test on a few shakes to get blood into the tips of your fingers.  This might be more important for you to do in the morning than the evening.
4. Get the lancet ready.  Do whatever you need to do like inserting it, or cocking the lancing device.  Just make sure it's ready to go.
5. Insert a test strip into the meter.  For me, the insertion of a strip turns the meter on, so I have never had to physically turn a meter on with an extra step.
6. Lance the side...the side of your finger.  It's less sensitive than your finger tip.  I have no clue why every picture I have ever seen of someone lancing their finger shows them using their finger tip.  It hurts far more than using the side of your finger.  In fact, I don't even feel the lance about 50% of the time on the side of my finger.  By the way, I have used one of two fingers on the same hand for the last few years - I don't vary it.  Do what's best for you, though.
7. Squeeze your finger a bit so a drop of blood appears.  It doesn't take much to test - far less than a drop.
8. Apply the testing strip to the drop of blood.  It will pick up the blood it needs through capillary action.  Be careful not to touch your skin with the strip - it could pick-up contaminants that will effect the reading.
9. Rinse the blood off of your finger as your meter gives you results.
10. Dispose of the lancet properly - in a medical sharps container.  DO NOT put it in the trash.
11. Dispose of the testing strip in the same manner.
12. Record your reading on your log.
13. Put your meter and supplies away.

I know supplies can be a bit pricey, but use lancets and strips only once.  That's important so I will repeat it - use lancets and strips once and then discard properly.

You have done it!  You have taken the test you cannot fail.  But, will fail in your battle on diabetes if you do not test!

There are so many meters on the market, that I won't get into any one brand right now.  If you do not know what your meter is capable of, or the information you can gain from it - learn.  Read the directions that came with the meter, or find them on the internet at the manufacturer's site.

As always, thank you for reading.  Fight the good fight and you will win your war with diabetes.

"Victory is always possible for the person who refuses to stop fighting." ~Napoleon Hill

"Be kind, for everyone you meet is fighting a hard battle." ~Philo

Your Best Friends in the Kitchen

If you are at all like me, after being diagnosed with diabetes, you are kind of afraid of the ktichen.  Afterall, that is where it might have all happened.  there is no need to be afraid of the ktichen - it's one of the best rooms in the house to win the war on diabetes. 

I remember before I heard those words, "You have diabetes." I loved kitchen tools.  Why?  I had to make sure I was putting enough sugar in the cookies...and butter.  Can't forget the butter, can I?  I am not kidding.  Measuring cups were used most of the time to measure sugar.  In just about everything.  I even found out a little bit of sugar made pasta sauce better!

Well, now I have new uses for the measuring cups, spoons and even a scale - to make sure I am getting the right portions.  I know, you can eyeball what three or four ounces of meat look like without a scale (kind like a deck of cards), but if you have a scale you will know exactly.  Okay, I am going on about a scale, but to tell you the truth, I learned the visual clues on some items, which can be found here.  I am actually a bit too lazy to weigh my food.

However, I have used measuring cups from Day One for a lot of foods like berries and cereals.  Look at cereal boxes to determine what a real portion size is - or at least what they use to base the nutrition information.  I have found it to be somewhere between 1/2 and 3/4 of a cup.  Measure it out and put it in a bowl - and that's it besides a bit of milk.  You don't get to add more cereal.  Add a piece of whole wheat toast (I never, ever thought I'd be advocating whole wheat anything!), if you need to add food, or add a 1/4 cup of berries.

Whatever you do read labels, know what you are getting nutritionally and get in the habit of measuring everything until you can eyeball it.  But, beware of CREEP.  What is creep, you ask?  It's when you subconsciously make the portion sizes bigger as you eyeball portion sizes.  I found I need to check the portion sizes every couple of weeks just to make sure I am still adhering to the portion guide lines.  It's way too easy to make them bigger than they should be if you aren't using a measuring cup.

I can hear you now, "I don't have a measuring cup."  Go out and get one either at a Target or Walmart, or you can even go to your local thrift store.  Wherever you get your measuring cups and spoons, make sure you wash and sterilize them prior to using.  Yes, you will need the spoons, too.

Learn the portion sizes.  Use measuring tools in the kitchen - they will become your new best friends.  Learn visual clues to portion sizes.  Learn carb counts of the foods you eat.  Lots of learning going on, but it will pay-off very quickly as your glucose levels and weight drop.

You are in a war - make you sure have the right weapons.  Your fight starts in your kitchen.

And, if you eat out often, learn what you can eat at the places you enjoy by looking at nutritional guides that most places have easily available.

This is such an exciting time for you as you start your battle in earnest.  You can win the war and control diabetes.



Measuring cups. Measuring spoons. Maybe a scale.

Shakes and Quakes

When I was first diagnosed I had no clue how to eat.  It seemed like I could eat too little or too much if I weren't very careful.  Too much and my sugar would be high.  Too low and I could go into a diabetic coma or have the effects of low blood sugar - aka hypogycemia.  Neither of which really appealed to me to say the least.  I wanted to avoid high sugar readings because, after all, I was (am) a diabetic.  And, I really wanted to avoid those low sugar shakes and quakes.

You know what?  I was successful on both counts.  I did have one day where I had a glucose reading of 59 - pretty low in anybody's book, and had only limited effects before I had sense enough to eat.  So, what did I do?  What did I eat?

I started with being having meals of about 60 carbs - give or take 5.  Snacks stayed around 15 carbs.  But - and here is the big secret...drum roll if you please...I ate six smaller meals of about 30 to 35 carbs.  It seemed like I was always eating.

Think about it.  Breakfast at 6:30. Snack at 9:00 or 9:15. Lunch around 11:30. Another snack around 2:30 or 3:00.  Dinner at about 6:00.  And yet another snack at around 8:00 or 8:30.  Each of these meals was 30 or 35 cabs.  Six meals of 35 carbs each means I was getting somewhere around 210 to 220 carbs a day.  That was really enough food for me.

Enough food?  Yes - it's what I needed to live, work and exercise AND lose weight.  Was I hungry sometimes? Well, yeah.  Think about it.  I had been eating what 350 or 400 carbs a day.  That's a lot.  No wonder I had diabetes.  Does not take a brain surgeon, does it?  My stomach needed time to catch up with my lower intake...it had to shrink.

But, I have got to tell you a secret - you can eat enough food and not be full.  You see, somewhere between your stomach and brain there seems to be a lag so that when you have actually eaten more than enough you really won't feel 'stuffed' until 10 minutes later.  That's one reason why we over-eat.  I don't know the science behind that phenomenon, I just know it's true.

Soon I will have to write about what 'enough food' really means.  But, in a nutshell, it's the amount you need to go through your day in a healthy manner.

So, there's a rule for you - start eating with your brain!

Eat six smaller meals as you start to lower your blood sugar.  If you are interested, I will list what I ate in the beginning - just ask.  It's different that what I eat now that I am in maintain mode.

Keep fighting the good fight to manage your diabetes.  It's not easy some days, but well worth it.

Thank you for reading.

Diet and Exercise - General Routine

A question about my general diet and exercise was asked and I thought this would be a good time to introduce the topic.  I will go into more detail in future posts.

Diet and Exercise are the two of the most important ways for you to control your blood sugar, cholesterol and general well being.  For a diabetic there is only one more important item - TAKE YOUR MEDS AS PRESCRIBED!

The exercise part is the easier one to answer.  I walk.  I walk 5 or 6 days a week for about 30 minutes.  Sometimes it's 35 or 40 minutes because I decide to walk a bit farther.  I walk because it's something I can do easily and gives me a time to consider life in general, see the neighborhood and at least say hi to folks I see.  Once I start my walk, I do not stop. 

I walked for the first 2 1/2 years in old shoes that my wife wanted me to throw away. Yes, my shins ached a bit, but I would rather have a little ache than have a high A1c.  The first day I walked maybe 3/4 of a mile in 30 minutes, but the important thing was that I was doing something.  Over time my pace increased, so I go much farther in 30 minutes now.  My normal 'walk' pace is 120 paces per minute; I have several areas of my walk where it increases to 132 paces per minute.  My walk is done on level ground.

Do you know the most important reason I walk?  I hate the idea of going to a gym and I think I might dislike the idea of actually running almost as much.  Now, you know.

Don't worry about the 'right' shoes, by the way.  Just get out and start walking.

I think my next blog entry is going to be on diet, at least where I began, which is not where I am today.  I stay to about 45 or 50 carbs for breakfast - whole grain cereals, hard boiled eggs (no more than four per week), toast (whole wheat and high fiber - found a great brand that does not taste like cardboard), blue berries and black berries mixed (a little over 1/2 cup each), very low carb yogurt like stuff and coffee with a splash of milk.  Now, understand I do not have all of that at the same time!  I mix and match to get to a carb count.

Lunch is a sandwich of turkey (not my favorite), left-over roast, peanut butter (watch the portion size), ramen like noodles (watch the carb count), maybe low carb yogurt stuff, fruit, fresh raw vegetables, and iced tea to drink (unsweetened).  I will have the occasional hamburger (but they normally come in at 55 carbs by themselves).  Again, I mix and match to get to 50 + or - carbs.

Dinner is a taco type salad with a piece of bread or corn tortilla, roast, salad, broiled or rotisserie chicken, fish, fish tacos (2 and I use corn tortillas) and iced tea to drink.  Again, I use 50 carbs as the magic number. 

For snacks I use low carb yogurt stuff, low carb granola bars (that really are good), fruit, half of a peanut butter sandwich, fresh raw vegetables.  Most snacks I try to keep to 15 cards, more or less.

When I drink milk, which I love, I use 2%.

If it would assist you, I would be glad to use Twitter to list what I eat for a specific meal, or meals.  I would record and send out everything I eat.  I don't claim to be an expert, but I have found what works for me to keep my A1c and weight where they should be.  If I can help you, I'd like to.  I would also let you know when I found a great food or product that would help you.

Again, thank you for reading.

"The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology or the president. You realize that you control your own destiny."  Albert Ellis

First Steps

Well, I had just found out I had diabetes that morning.  Not one of my better mornings.  I was afraid, but was determined not to be a victim of the disease.  I might (no might about it with my A1c) have diabetes, but diabetes did not have me.  It was important for me to make that distinction and statement.

The first marching orders from my doctor: Get the medication started because he wanted to get the A1c down as soon as possible, and lose a little weight.  I am so glad he did not tell me I had to lose 60 pounds.  I am not sure I would have been so aggressive in getting the weight off.  A 'little weight' is so much easier to lose!  Of course, I heard 'just a little more' for quite a few months.

Obvious foods were out for me.  You know what they are - sugar in just about any form, a lot of starches, no rice (I loved rice), white breads, etc.  Load up on vegetables (didn't know that I liked that idea).  So, no more cookies - and I have never met a cookie I didn't like.  And, of course, pies, cakes, ice cream, etc. were off the menu permanently.

The simple fact of life is that I had to change the way I ate.  So, I decided one of my first steps was to start and maintain a food log or diary.  EVERYTHING I ate got recorded.  I found an unused 'scratch' pad around the house and started writing down what I ate.  I used a simple format: Breakfast, Snack, Lunch, Snack, Dinner, Snack (B, S, L, S, D, S).  I wrote down every little thing and I put a carb count next to each meal

What? Carb count?  Yep, I am one of those who counts carbs - still do.  In the beginning I allowed myself about 60 carbs per meal and 15 carbs per snack.  Each day had a maximum possible of 225 carbs.  Where did I get this idea?  I think I eventually got it from a on-on-one with a dietician - unfortunately I can't accurately recall. (Sounds like I am answering a question during a Senate Investigation.)  Where ever I got it, it worked for me.

You have to remember where I was coming from.  100 or 150 carb meals were the norm.  I ate what I wanted when I wanted.  You might be coming from the same place.  Pizza.  Pastas. Breads of any sort. And, potatoes.  It doesn't take much for me to accurately imagine a baked potato with butter, lots of butter on it.  So, from 150 carbs per meal to only 225 for the day.  I really, really, really wanted to re-think this approach, but knew in my heart I didn't have any alternative.

In fact, I reduced the total number of carbs consumed daily (now, that really does sound like a label on a product) over the next few weeks to between 190 and 200.  But, I knew what I was eating and where I could reduce.  Why?  Because I kept my food diary.

By the way, at the top of every page, I put my morning glucose reading.  I knew the general goal was to see it go down to below 120.  I started with something over 300, but between the medication and the change in what I ate, I saw it go down everyday which served as a reinforcement for my eating.  Seeing the glucose number helped me be more successful.  It became a game for me!

So, please get your food diary started.  Even now when I need to make an adjustment - like lose a few pounds (more on that later), I start keeping a diary and I can immediately see where I need to make adjustments.

Now, most of my meals are aorund 50 to 55 carbs and my snacks are about 12 to 15 carbs.  I only know that it works for me.  As an alternative you might want to try six small meals at about 30 carbs each.

Want to know carb counts on some basic foods?  Look here.

You can do this!  Diabetes is the enemy and you ARE going to vanquish it with a bit of time and planning.

"Life is 10% what happens to you and 90% how you react to it." Charles R. Swindoll

By The Numbers

Just a reminder that I am writing about Type 2 Diabetes.  Sometimes called Adult Onset Diabetes, which just means you did not have diabetes as a child and are probably on some sort of oral medication.  

One of the first things I did was find out how many people had diabetes.  I knew the number was kind of big, but had no idea it was HUGE.  Take a look here to get the information.

But, let me summarize for you.  Almost 26,000,000 (that's 26 million, but it looks even bigger when you see the 0's) either have been diagnosed with diabetes or have diabetes and have not been diagnosed.  That's a lot of folks!  8.3% of the population.

But, wait, there's more - just like those darn Ginsu knives of TV fame.  Those who have pre-diabetes number around 75,000,000.  Put those numbers together and you get 100,000,000 people with some form of diabetes.  That is about 30% of the population.  No wonder the Center for Disease Control is involved with diabetes.  You know about the CDC - the folks who store test tubes of typhoid; the folks who deal with deadly diseases.  Guess what?  Diabetes, if not managed or controlled, is slow death.  (That, I hope is my only attempt at scaring you.)

By the way, if you want to learn more about prediabetes, you can read about it here.

The good news? Diabetes can be controlled and/or managed with a bit of care and common sense.  That is not just good news, it's great news!!!

So, what is diabetes?  In a nutshell, the body uses insulin, which is naturally produced by the pancreas.  For some reason, your body no longer recognizes the insulin, or does not have enough.  Sugar in your blood rises (not a good thing) and before long, you have diabetes.  Now, that's the short and simple explanation.  If you want one that is more complete, you can read it here.

So, you know you are not alone, which was important to me to know, and you know it can be controlled.  You are already making progress.

By the way, the first time I ever measured my blood glucose with a meter it was 357.  I am fairly confident you know that is a pretty big number.  It was not reassuring, but was motivating!  More about your daily glucose numbers and A1c in the next post.

Thanks for reading.

“If you're reading this...
Congratulations, you're alive.
If that's not something to smile about,
then I don't know what is.” Chad Sugg

Welcome!

Thank you for coming to this blog.  I have been thinking about it for weeks before posing my first entry.  You see, by starting this blog, I think I have a responsibility to continue to write and I take that seriously.  My hope is that you will find some value to what I write.

Three things happened recently to propel me to write this blog:

1. My diabetes nurse (part of my Treatment Team) told me I should think about being a Diabetes Trainer because I have been successful, in her mind, at managing diabetes.  
2. I was asked what I would do differently if I had a million dollars.  I don't have that kind of money, but it really caused me to ask myself what I would like to do.  The answer: Make a difference in people's lives.
3. I was talking with a client who told me one of his folks was out with a leg infection.  Of course, I thought diabetes - which I later found out was correct.  After asking about the prognosis, I thought it was totally avoidable - it did not have to happen.  I began to think about ways I could reach out to others to let them know they did not have to be victims.  And, a blog was born. (If you have any ideas on how to get folks to take a look at it, if you find it valuable, I will gladly take the help.)

So, I hope you get a bit of encouragement.  Smile once in a while.  And, comment when you want to.


A bit about me.  I am a diabetic.  I was diagnosed about three years ago when after a routine (what I thought was routine) series of blood tests.  My doctor's office called and told me I needed to come in.  They told me it had to do with the test results.  Well, I had a few days of rampant, raging fear not having any idea what was going on.

After I got into the doctor's office, he came directly to the point.  I had an HBA1c of about 13.1.  I remember looking at him and wondering what that meant.  He said it was a 'bit high' and that I had diabetes and that I would probably have to take pills the rest of my life.  I don't know what the rest of you thought when you heard the news you had diabetes, but I thought of all of the horror stories of lost feet, legs, blindness and organ failure.  To say I was scared is an understatement.

My doctor started me on good ol' Metformin and told me to return in several weeks after another blood test.  He also said that I had to 'lose a little weight.'  I came back and he changed the medication to Janumet - my A1c was not dropping fast enough for him, and I was scared, again.  Two months later my A1c was down to around 7.  He changed my medication back to Metformin and my numbers continued to drop.  My A1c seems to have stabilized around 6 - and sometimes under.

What have I done?  I changed my diet immediately.  I began to exercise.  I looked at the American Diabetes Association website.  Learned about BMI's.  And all sorts of stuff that I was clueless about.

This blog is about my journey toward diabetes management.