insulin resistance - wellrx blog image

By Karen Eisenbraun, CHNC

Diabetes is a serious health condition that affects more than 34 million Americans. More than 90% of people with diabetes have a form known as type 2 diabetes. Type 2 diabetes most often develops later in life but can also affect children and teens. 

Diabetes is linked to serious health complications, including kidney disease, nerve damage, impaired wound healing, skin conditions, and eye damage. Severe cases can lead to blindness or limb amputation. Some long-term complications of diabetes can be life-threatening.

While type 1 diabetes is a genetic condition that cannot be cured, type 2 diabetes is linked to many different risk factors, some of which can be controlled. One of the first signs of type 2 diabetes is a condition called insulin resistance. As much as 50% of people with insulin resistance or prediabetes will eventually develop type 2 diabetes. Fortunately, you can make lifestyle changes to reduce your risk of diabetes.

Are you paying too much for your diabetes medications? 

What Is Insulin Resistance?

Insulin resistance occurs when the body no longer responds well to insulin. A hormone produced by the pancreas, insulin is responsible for moving glucose, or sugar, from the food you eat into the liver, fat, and muscle cells, where it is stored for later use. When the body becomes resistant to insulin, it leads to high blood sugar, a condition known as hyperglycemia, which can become a serious health problem. 

How Do You Know if You Have Insulin Resistance?

Insulin resistance often doesn’t cause any noticeable symptoms, so it’s possible to be resistant to insulin for years without even knowing it. You are at greater risk of insulin resistance if you are overweight, have high triglycerides, or have high blood pressure. Some people with insulin resistance develop dark patches of skin on the neck or in the armpits. 

If you think you are at risk of insulin resistance, talk to your doctor. There is no one test for insulin resistance, but your healthcare provider can monitor your blood sugar and check for symptoms of diabetes. 

How to Reverse Insulin Resistance

If you are starting to become resistant to insulin, you can make several lifestyle changes to improve your body’s response to insulin. Don’t wait until you are diagnosed with diabetes to begin adopting healthier habits. The earlier you start making changes, the better. 

Exercise Regularly

Regular exercise is one of the best things you can do for your overall health. Exercise burns off excess blood sugar, which can lower your blood glucose levels and improve your body’s insulin response over time.

If you are mostly sedentary, start getting more activity into your day. Choose an activity you enjoy, and try to do it at least three times a week. That could be walking, swimming, yoga, cycling, or even dancing. Moderate activity is best, but any activity is good. Get the family involved by playing a game outside while the weather is nice or taking a walk around the neighborhood in the evening. 

Avoid Sugar and Simple Carbohydrates

Foods that are high in sugar will increase your blood sugar. This includes simple carbohydrates such as white bread, pasta, and baked goods. As much as possible, avoid foods with added sugars; instead, choose complex carbohydrates. 

When you go grocery shopping, get in the habit of reading the nutrition facts panel and ingredients lists on the foods you buy. Many packaged foods are loaded with sugar. Check the ingredients for words such as sucrose, fructose, dextrose, brown sugar, syrup, corn syrup, corn syrup solids, cane sugar, and cane juice. 

You can also look for foods made with sugar alcohols, which don’t impact blood sugar the same way that sugar does. Common sugar alcohols include xylitol, maltitol, and erythritol. Use caution with sugar alcohols because they can cause gastrointestinal distress in some people. 

Choosing healthier foods may feel overwhelming at first, but eventually, you will find brands that you know you can trust. 

Eat More Complex Carbohydrates

Complex carbs, which include fruits and vegetables, have less of an impact on blood sugar. Make sure to get plenty of fresh plant foods in your diet. Ideally, every meal should include plant foods, protein, and a healthy source of fat. Instead of serving bread or rice with your dinner, choose another vegetable or a side salad. Including quality sources of protein and healthy fats in every meal will also help you avoid the energy crash that follows after you eat something high in sugar. 

ScriptSave’s Grocery Guidance app can help you find healthier alternatives to some of the foods you buy most often. Simply scan the barcode on any food package to reveal its WellRx Health Index and discover “better for you” alternatives. Download the app on the App Store or Google Play to get started. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.cdc.gov/diabetes/basics/type2.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891203/

https://www.wellrx.com/health-conditions/about/health-condition/type-2-diabetes/~default/

https://www.wellrx.com/grocery-guidance/

how to store insulin - wellrx blog image

Insulin is a life-saving medication for people with diabetes, but it can also be hard to keep it stored correctly. Insulin that isn’t kept in the right conditions may not be effective. Here are some storage tips to keep in mind. Ask your doctor or pharmacist if you have any questions about your specific type or brand of insulin.

Get the Right Temperature

Insulin is very sensitive to temperature. Store your vial or insulin pen in the refrigerator until you open it. The temperature should be between 36 and 46 Fahrenheit (2.2 to 7.8 Celsius); use a thermometer in the fridge to get an accurate reading.

Store insulin at room temperature once you open it. Avoid direct sunlight and extreme heat or cold (such as the freezer or a hot car). Although it can seem like a good idea to keep a back-up supply of insulin in your glove compartment, keep in mind that your car is often subject to extreme heat and cold.

Keep Track of When You Opened the Insulin

When you open a new insulin vial or pen, write down the date and dispose of it after 10 to 28 days have passed. Check with your doctor or pharmacist to confirm how long your type of insulin will last, but most have a lifespan in this range. Always dispose of insulin after the manufacturer’s expiration date, regardless of when it was opened.

Visually Inspect Your Insulin Before Every Use

As an added precaution, always inspect your insulin before you use it. Look for particles, discoloration, clumps, frost, or crystals. Make sure the insulin is clear, not cloudy.

How to Store Insulin When Traveling

It can be more challenging to store insulin when you’re traveling. Plan ahead before your vacation and be careful where you leave your diabetes supplies while on vacation. Here are some tips from the Centers for Disease Control and Prevention (CDC) to keep in mind.

If you’re flying:

Pack insulin in your carry-on bag. Checked baggage may be subjected to more extreme temperatures. Also keep some insulin in a smaller bag or purse so that you can have it with you during the flight.

When going through airport security, be mindful of the X-ray machine. According to the CDC, the machines can damage an insulin pump or glucose monitor. People with these devices should ask for an alternative security inspection.

If you’re driving:

Store insulin in a cooler, but avoid direct contact with ice or a gel pack. Don’t leave any of your diabetes supplies (blood sugar monitor, test strips, etc.) in a hot car. If you stop for more than a few minutes, bring your supplies with you.

What to Do if Your Insulin Is Damaged While Traveling

If your insulin is frozen, exposed to extreme heat, or you notice the appearance is off, don’t use it. Locate a nearby pharmacy for a new supply of insulin. You should be able to get a prescription in a different state in most cases. It’s a good idea to take a medication order (paper copy of your Rx) with you on vacation. Alternatively, you can transfer your prescription or ask your doctor to call it in to the pharmacy.

Properly storing insulin is just one of the challenges of living with diabetes. Cost is another major concern for patients. In recent years, insulin prices have gone up.

Some patients struggle to pay for their medication. If you’re one of them, try searching for your prescription on WellRx.com. We offer discounts on many types of insulin and other diabetes medications. You may even find that our discounted price is better than your insurance co-pay!

trijardy xr diabetes - wellrx blog image

By Rosanna Sutherby, PharmD

The Food and Drug Administration (FDA) approved Trijardy XR in January 2020 for lowering blood sugar in patients with type 2 diabetes. This new medication combines the effects of three antidiabetic drugs to simplify your treatment plan and help you achieve your target blood sugar level.

What Is Trijardy?

Trijardy XR is a combination antidiabetic medication. It contains the drugs empagliflozin, linagliptin, and metformin. Empagliflozin is the active ingredient in Jardiance, linagliptin is the active ingredient in Tradjenta, and metformin is the generic version of Glucophage.

Trijardy XR is used along with diet and exercise to control blood sugar in patients with type 2 diabetes and to reduce these individuals’ risk of heart-related death. You should not use Trijardy XR if you have type 1 diabetes.

How Does Trijardy XR Work?

Trijardy XR helps to lower blood sugar by three mechanisms. The empagliflozin (Jardiance) component of Trijardy XR works by preventing your kidneys from absorbing sugar and allowing your body to excrete it in the urine. Linagliptin (Tradjenta) works by helping your pancreas produce more insulin and by signaling your liver to stop making sugar when there is too much in your blood. Metformin (Glucophage) works by reducing the amount of sugar that your liver produces and the amount of sugar that your intestines absorb. It also makes your body more sensitive to insulin.

How Do You Take Trijardy XR?

Trijardy XR is usually taken once a day with a morning meal. Your doctor will determine your dose based on your blood sugar control and kidney function. Take this medication according to the prescription label. Swallow the tablets whole, and do not chew, crush, or cut them.

What Are the Benefits of Taking Trijardy XR?

For some people, controlling their diabetes can be a challenge. Often, keeping your blood sugar at a target level requires a treatment plan that includes several medications. Combining three different medicines into one tablet reduces the number of pills that you take daily and makes it easier for you to remember to take your medication regularly at the right time.

Additionally, each component of Trijardy XR lowers your blood sugar by a different mechanism. The three drugs work together in various organs of your body to help you reach your target blood sugar level.

What Are the Side Effects of Trijardy XR?

All medications have side effects, but not everyone experiences them the same way. Potential side effects of Trijardy XR include the following:

  • Upper respiratory tract infection
  • Urinary tract infection
  • Diarrhea
  • Constipation
  • Headache
  • Gastroenteritis (infection and inflammation of the stomach and intestines)
  • Hypotension (low blood pressure)
  • Hypoglycemia (low blood sugar)
  • Joint pain

The following side effects are less common but require immediate medical attention if they occur:

  • Pancreatitis
  • Heart failure
  • Sudden kidney failure
  • Gangrene

Trijardy XR can cause lactic acidosis, which is a critical condition when you have too much acid in your blood. Let your doctor know immediately if you experience the following symptoms:

  • Nausea
  • Vomiting
  • Stomach pain
  • Unusual tiredness
  • Breathing problems

If you have kidney or liver problems, talk to your healthcare provider before taking Trijardy XR.

Can I Take Trijardy XR If I Am Pregnant or Breastfeeding?

If you are pregnant, you should talk with your obstetrician-gynecologist (ob-gyn) before taking any medication.

Trijardy XR is not recommended during pregnancy. Talk to your ob-gyn about safe alternatives if you have diabetes during your pregnancy.

The manufacturer does not recommend using Trijardy XR if you are breastfeeding due to the risk of kidney damage to the baby.

Can I Compare Prescription Prices Before Filling My Diabetes Medication

Keeping your diabetes under control often requires a treatment plan that includes several drugs. The cost of all your medications can quickly add up when you are paying for them every month. If your insurance plan does not cover your medications or the price is too high on insurance, you can use a free Rx savings card to get the lowest prescription price.

How Do Prescription Discount Cards Work?

Prescription drug cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. Sometimes, you may find that your insurance plan does not cover your medication or that the price with insurance is higher than the cost with a prescription savings card. Using prescription savings cards may save you up to 80% or more off the retail price. Be sure to compare prescription prices before filling your prescription. You can use the ScriptSave® WellRx discount card for the best discount at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/212614s000lbl.pdf

https://www.wellrx.com/hn/us/assets/health-condition/type-2-diabetes/~default

https://www.wellrx.com/trijardy%20xr/drug-information/

https://www.wellrx.com/jardiance/drug-information/

https://www.wellrx.com/tradjenta/drug-information/

https://www.wellrx.com/metformin%20hcl/drug-information/

https://www.wellrx.com/hn/us/assets/health-condition/hypoglycemia/~default

https://www.wellrx.com/family-prescription-savings

https://www.wellrx.com/discount-pharmacy-priceshttps://www.wellrx.com/prescription-discount-card

humalog blog image - scriptsave wellrx

by Ryan Lowe, PharmD Candidate,
The University of Arizona College of Pharmacy

For many patients with diabetes, insulin has become a mainstay of their therapy. Despite the addition of newer drugs on the market (like the exciting GLP-1 agonists such as Victoza (liraglutide), insulin remains a popular choice among physicians for its numerous benefits. The dose of insulin can be easily adjusted; if your blood sugars are running high then simply try taking two more units and reevaluate in a couple of days. Insulin is also a great drug when used in combination with other medications such as metformin; these combinations allow for greater control of a patient’s diabetes. According to a study from the CDC, the percent of patients taking both insulin and an oral medication increased between 1997 and 2011. This suggests the importance of both types of medication in diabetes management. 1

What are the different types of Insulin available?

Insulin can be divided up into two categories: long acting and short acting. Most patients start out with a long acting insulin before a short acting insulin is added. The most common long acting insulin is Insulin Glargine, or Lantus. Another long acting insulin you may see is Insulin Detemir, or Levemir. These insulins are normally dosed once a day, and they work to keep your fasting sugars (your blood sugar when you’re not eating any food) within normal limits.  The most common side effect of long acting insulin is hypoglycemia, or low blood sugar. When you take too much insulin your body eats up too much glucose, resulting in low blood sugar levels. If you are hypoglycemic then you may start shaking, feeling dizzy or faint, and feel confused or anxious. The quickest remedy for this is eating a high sugar snack or drink, such as a glass of orange juice. As noted earlier, one of the main benefits of long acting insulin is being able to adjust the dose more frequently to find the perfect dose for you. With a tablet medication it is harder to find the perfect middle ground; you either take one tablet or you take two. Insulin doesn’t work that way; since insulin is a liquid injection you can easily take a little more or a little less than you were previously to account for your blood sugar levels.

Short acting insulin works much quicker than the long acting insulins, hence the name. There are two common short acting insulins: Insulin Lispro, or Humalog and Insulin Aspart, or Novolog. These insulins are commonly taken after a meal. The idea behind this is that the insulin will counteract a large spike in blood sugar gained by eating a large meal. However, these insulins are rarely taken alone; rather they are normally used in combination with long acting insulin to combat both types of sugars: fasting and post-prandial, or post-eating sugars. Hypoglycemia is still a risk with these short acting insulins, but it isn’t as great a risk as with the long acting insulins. One consideration that has been on many patient’s mind, however, is the rising cost of insulin – and Humalog specifically has been in the news lately.

Why is Humalog making headlines?

Humalog is a short acting insulin manufactured by Eli Lilly, a drug company responsible for numerous popular medications. Eli Lilly released some pricing information about Humalog, and the numbers are raising some eyebrows among patients, healthcare providers, and even politicians. An insured patient will typically pay around $135 a month for Humalog (which is a decrease of 8.1% from 2014). When you don’t factor in the rebates typically covered by an insurance company, the monthly price of Humalog rises to $549.2 These differences have gotten a lot of people talking. Eli Lilly hopes that the information they released will help shed some light on the often-muddled issue of rising drug costs. Politicians on both sides seem to agree that drug costs need to come down in America, but the solution to this issue is not an easy one. Eli Lilly themselves hope to improve the situation by releasing a “half-price” Humalog under the generic name Insulin Lispro. The cost will be $137.35 per vial, which should significantly improve the annual cost for those uninsured patients with diabetes.3

In response to the Eli Lilly price drop for Humalog, Sanofi recently announced a program that they hope will make a difference in the cost of insulin.4 They unveiled a Netflix-like program that takes that model directly to patients, supplying insulin products for a flat monthly rate instead of the usual cost per prescription or refill. The drugmaker will use its Insulin Valyou Savings Program to deliver insulin products for $99 per month. For that monthly fixed price, Sanofi will offer up to 10 boxes of insulin pens and 10 mL vials per month, regardless of a patient’s income. The new $99-per-month price could be as little as one-tenth of the amount patients would have paid previously.

References:

  1. “Age-Adjusted Percentage of Adults with Diabetes Using Diabetes Medication, by Type of Medication, United States, 1997–2011.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Nov. 2012, www.cdc.gov/diabetes/statistics/meduse/fig2.htm.
  2. Lovelace Jr., Berkeley. “Eli Lilly Sheds Light on Confidential Pricing, Discloses Charges for Popular Diabetes Drug Humalog.” CNBC, CNBC, 25 Mar. 2019, cnbc.com/2019/03/25/eli-lilly-discloses-pricing-data-for-its-popular-insulin-humalog.html.
  3. “Lilly to Launch a Half-Price Version of Insulin.” CNBC, CNBC, 4 Mar. 2019, www.cnbc.com/2019/03/04/lilly-to-launch-a-half-price-version-of-insulin.html.
  4. “Sanofi provides unprecedented access to its insulins for one set monthly price” Sanofi, 10 Apr. 2019   http://www.news.sanofi.us/2019-04-10-Sanofi-provides-unprecedented-access-to-its-insulins-for-one-set-monthly-price 

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