Lisinopril (Zestril)
[20mg tab - twice daily] Used to treat high blood pressure, and in some cases, heart failure. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.
Hydrochlorothiazide
[25mg tab - mornings] Used to treat high blood pressure. It causes the kidneys to get rid of unneeded water and salt from the body into the urine. May reduce the level of potassium in your blood.
Hydralazine
[25mg tab - twice daily] Used to treat high blood pressure, Hydralazine is called a vasodilator. It works by relaxing blood vessels so blood can flow through the body more easily.
Amlodipine Besylate
[5mg tab - mornings] A channel blocker used to treat high blood pressure (hypertension) and a type of chest pain called angina. It can be used by itself or with other medicines to treat these conditions.
Potassium
[1 tab - evenings] Potassium Chloride Extended Release Tablets are an electrolyte replenisher used to treat low levels of potassium in the blood (hypokalemia). Potassium helps your cells, kidneys, heart, muscles, and nerves work properly.
Plopidogrel
[75mg tab - mornings] An antiplatelet medicine. It prevents platelets (a type of blood cell) from sticking together and forming a dangerous blood clot. Taking clopidogrel helps prevent blood clots if you have an increased risk of having them.
Multaq
[400mg tab - twice daly] (Dronedarone) A Class III antiarrhythmic drug that works to restore the normal sinus rhythm in patients with persistent atrial fibrillation.
[25mg tab - twice daly] A beta-blocker, it affects the heart and circulation. Used to treat heart failure and hypertension. It is also used after a heart attack that has caused your heart not to pump as well. IMPORTANT: In the event of Afib, where heart rate is high (130 to 140 bpm), take one additional 25mg tablet and monitor to see if heart rate comes back down into normal range. If heart rate remains high, go to ER.
Atorvastatin
[20mg tab - evening] Reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).
Xarelto
[20mg tab - evening] used to prevent blood clots from forming due to a certain irregular heartbeat (atrial fibrillation).
Potassium Chloride CR
[10mg tab - evening] a mineral supplement used to treat or prevent low amounts of potassium in the blood.
Gabapentin
[300mg tab - one pill in the morning and 3 pills at night] Gabapentin is taken for nerve pain, which can be caused by different conditions, including diabetes and shingles. It's also used to treat epilepsy; it's thought that gabapentin stops seizures by reducing the abnormal electrical activity in the brain.
Carbidopa/Levodopa
[1 tab - Up to 3 times daily] This combination medication is used to treat symptoms of Parkinson's disease or Parkinson-like symptoms (such as shakiness, stiffness, difficulty moving). Parkinson's disease is thought to be caused by too little of a naturally occurring substance (dopamine) in the brain. Levodopa changes into dopamine in the brain, helping to control movement. Carbidopa prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain. Carbidopa can also reduce some of levodopa's side effects such as nausea and vomiting.
Flexeril (CYCLOBENZAPRINE)
[10mg - tab - 3 times daily as needed]
Flexeril is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.
Flomax (TAMSULOSIN)
[.4mg - tab - once nightly] Used to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH). Flomax is an alpha-blocker. It works by relaxing muscles in the prostate and bladder, which helps to improve urine flow and reduce symptoms of BPH.
Finasteride
[5mg - tab - once nightly] Finasteride (Proscar) is used alone or in combination with another medication (doxazosin [Cardura]) to treat benign prostatic hypertrophy (BPH, enlargement of the prostate gland).
Metformin (Glucophage)
[500mg - 2 tabs - twice daily] Metformin decreases the amount of glucose (sugar) you absorb from your food and the amount of glucose made by your liver; also increases your body's response to insulin.
Novolog Flexpen (short-term)
[inject 14 units before each meal + any correction] Fast-acting and works to help control blood sugar spikes when you eat. Eat within 5 to 10 minutes (not 30 min) after injecting.
Toujeo (long-term)
[30 units - mornings] Insulin glargine is long-acting and helps move sugar from the blood into other body tissues where it is used for energy. It also helps the body break down carbohydrates, fats, and proteins from the diet.
Jardiance (Empagliflozin)
[.25MG Tab - mornings] used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Empagliflozin is also used in patients with type 2 diabetes and heart disease to lower the risk of death from heart attack or stroke. Empagliflozin works by increasing the removal of sugar by your kidneys.
HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease. Aerobic exercise can help raise HDL. Moderate to vigorous aerobic exercise can boost HDL by 5% to 10%.
Triglycerides can also raise heart disease risk. Low triglyceride levels are always better, preferably below 100. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people. Niacin can be taken to lower cholesterol and triglycerides in the blood.
Healthy eating starts with healthy food choices. You don’t need to be a chef to create nutritious, heart-healthy meals. Learn what to look for at the grocery store, restaurants, your workplace and any eating occasion.
Visit Heart.org for more information on heart-healthy, diabetic food choices and lifestyle changes.
Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you're fasting and between meals. This is called background or basal insulin replacement. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. The insulin-to-carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 4-30 grams or more of carbohydrate depending on sensitivity to insulin.
The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. For some, however, this drop in blood sugar can range from 15 to 100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances.
Total Daily Insulin Requirement
First, you need to figure out your total daily insulin requirement. To do this, divide your current weight by 4. If you weigh 160 lbs, your total daily insulin requirement would be 40 units of insulin/day. If your body is very resistant to insulin, you may require a higher dose.
Establish a Basal/Background (Overnight) Dose
If your body is very resistant to insulin, you may require a higher dose. Your basal/background dose is generally 40 to 50 percent of your total daily insulin requirement (TDI).
Figuring Out Your Carb/Insulin Ratio (CHO)
Use the “Rule of 500”: 500 divided by your total daily insulin (TDI). If you weight 160 pounds and your TDI is 40, then 500 ÷ 40 = 12. Therefore, your carb/insulin ratio would be 1 unit of insulin to every 12 grams of carb, or 1:12. Some ratios change throughout the day, Your morning ratio might be 1:15 and your evening ratio might be 1:8.
Figuring Out Your High Blood Sugar Correction Factor
Use the “Rule of 1800”: Correction Factor = 1800 ÷Total Daily Insulin Dose = 1 unit of insulin will reduce the blood sugar by so many mg/dl.
Assuming your total daily insulin dose (TDI) = 160 lbs ÷ 4 = 40 units
1800 ÷ 40 units = 45, meaning that 1 unit of insulin will reduce your current blood sugar level by 45 points. Most people round this number to 40 or 50.
Please keep in mind, the estimated insulin regimen is an initial “best guess” and the dose may need to be modified to keep your blood sugar on target.
Also, there are many variations of insulin therapy. You will need to work out your specific insulin requirements and dose regimen with your medical provider and diabetes team.
Glycemic Index (GI) VS. Clycemic Load (GL)
The Glycemic Index or GI Index ranks carbohydrates based on how they make your blood sugar rise. Blood sugar (glucose) is what your body uses for fuel. It comes from the breakdown of carbohydrates. Simple sugars, (simple carbs), go right into your blood stream without having to be broken down or "digested." Complex carbohydrates need to be digested — in the mouth, the stomach or small intestine BEFORE they enter the blood stream. There is a simple way to track which foods cause fast or slow rises in your blood sugar.
Drippers have a low glycemic index between 0 and 55, while flooders have an index of over 70. These numbers are relative to Pure Glucose which has a glycemic index of 100. The higher the glycemic index, the faster your blood sugar will rise. This means that the flooders are easily digested and push glucose into the blood stream faster than drippers.
People with diabetes have high blood sugar. Scientists have discovered that proper (more evenly consistent) blood sugar levels are better. Too high = not good. Too low = not good.
Drippers cause blood sugar levels to rise slowly and it gives your body time to release the proper amount of insulin. For diabetes, managing blood sugar levels gives your body a chance to respond to a recently eaten meal. Flooders are not that kind; they overwhelm your sytem and lead to spikes and crashes in your blood sugar.
The glycemic load (GL)
The GI value tells you only how rapidly a particular carbohydrate turns into sugar. It doesn't tell you how much of that carbohydrate is in a serving of a particular food. You need to know both things to understand a food's effect on blood sugar. That is where glycemic load comes in. The carbohydrate in watermelon, for example, has a high GI, but there isn't a lot of carbohydrates in a watermelon, so it's glycemic load is relatively low.
The GI and GL of a food are related by the amount of available carbohydrates in a fixed serving of the food. The glycemic load of a food is calculated by multiplying the absolute GI value by the grams of available carbohydrate in the serving, and then dividing by 100. For example, a 225 g (1 cup) serving of Bananas with a GI of 52 and a carbohydrate content of 45.5 g (51.4 g total carbohydrate - 5.9 g fiber) makes the calculation GL = 52 x 45.5 / 100 = 24, so the GL is 24.
How to Switch to a Low GI Diet
The basic technique for eating the low GI way is simply a "this for that" approach - ie, swapping high GI carbs for low GI carbs. You don't need to count numbers or do any sort of mental arithmetic to make sure you are eating a healthy, low GI diet.