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These variables can create the impression that medication efficacy is declining when, in fact, external factors are the primary drivers of glucose variability

If its been more than 5 days, skip the missed dose and take your next scheduled dose

The pen should be discarded even if the solution appears clear

Eat smaller, more frequent meals four or five smaller meals beats three big ones Eat slowly, chew thoroughly, put your fork down between bites Stop when you're satisfied, not stuffed eating past comfortable fullness is the fastest route to nausea Stay hydrated aim for at least 64 oz of water a day, sipped throughout the day Don't lie down for at least 30 minutes after eating

Contact your doctor to find out what to do

*Initial Consultation has an additional $150 fee for lab ordering, EMR setup, etc