Managing Diabetes Medications If You are Blind or Low Vision: Part 6

Audrey Demmitt, RN, BSN, is a Diabetes Nurse Educator, APH VisionAware Peer Advisor, and author of the APH VisionAware multi-part blog series on diabetes and diabetes education. In this series, Audrey has covered how diabetes education can help lower your blood sugars and reduce the risk of diabetic retinopathy, the significance of the A1c test in the effective diagnosis, treatment, and management of diabetes, ways to make monitoring blood sugar easier, healthy eating, and exercising safely.

As we conclude this series for Diabetes Awareness month, Audrey discusses managing medications. As Audrey says, “Diabetes is a demanding disease, and it requires vigilance on your part. Taking your medications correctly is important in controlling your blood sugars.”

Medications Used to Treat Diabetes 

There are a variety of medications used to treat diabetes. Some people use only pills, while others use insulin from vials, preloaded injection pens, or programmable pumps. Still, others may use a combination of oral drugs, insulin, and other injectable drugs. No matter what, it is important to develop a system to ensure you are taking the right medication, at the right time, in the right dose, and in the right way. Taking your medications safely and correctly is critical to avoid dangerously low or high blood sugars. Taking your medications properly also helps avoid the complication of vision loss from diabetic retinopathy. 

Tips to Help Manage Your Medications Confidently when Blind or Low Vision

1. Get a low vision exam. The low-vision eye care specialist is trained to conduct a functional eye examination that focuses directly on how a person’s particular vision affects his or her day-to-day living. The specialist will prescribe low-vision devices such as magnifiers or electronic aids to help you manage your medications. A low-vision therapist can teach you about devices and lighting which can maximize your useable vision. 
2. Check into obtaining vision rehabilitation services. Vision rehabilitation therapists can teach you about adaptive equipment and special techniques to manage medications. Check out the APH directory of services to find services near you. 
3. Talk to your healthcare team about your vision changes. Be sure they are aware of the challenges you are having with your diabetes self-care. Ask your doctor for information that you can access with your level of vision. Request classes from a diabetes educator who can work with you to personalize your medication routines and help you problem-solve. You may want to check out APH VisionAware’s Diabetes Guides to get started.  
4. Talk to your pharmacist. Be sure you understand what types of medications you are on and how they work, how to take them, and how to store them. Request large print instructions and labels on medicine bottles and explore talking prescription bottle programs. Many pharmacies, including most of the major drug stores and the Veterans Administration, offer devices with “audio” instructions and even alarms to remind you when to take your medicines. Your pharmacist is a great resource for information on your medicines and diabetes supplies.  Additionally Accessible Pharmacy, a mail-order pharmacy, can deliver medications and supplies to most states. To find out if your state qualifies, visit the Accessible Pharmacy website. They provide numerous accessible devices, such as ScripTalk, large print labels, braille labels, and special packaging options all free of charge. They also provide education and assistance via telephone or the Be My Eyes app, 
5. Mark your medicine bottles. Use bold and high-contrast markers to label bottles, vials, and other supplies. Rewrite the instructions and expiration dates on a card and attach to the original container. Handheld magnifiers can help with reading labels, expiration dates, and instructions. Colored tape, rubber bands, fabric paint, and tactile bump dots can be useful to distinguish between long-acting insulin and regular insulin vials or morning meds and bedtime meds. Be creative and discuss ideas on ways to organize and label medicines and supplies with your vision rehabilitation therapist to develop a system that works for you. 
6. Consider using an insulin pen instead of syringes. Preloaded insulin pens may be easier to use than a syringe and vial which requires drawing up each dose. Pens have fewer steps to use and audible “clicks” that can be counted when the dial is turned to set the proper dose which helps prevent errors. Changing the pen needle is recommended after each injection. Use a days-of-the-week pill organizer to help you remember if you took your daily dose from your pen. Fill each slot with an unused pen needle at the start of the week. Use the needle for that day’s injection. When unsure if you took your shot, check the day’s box. If there’s a needle, you haven’t taken your insulin yet. 

Tools for Dosing

• Dosing tools help to draw up insulin safely and measure accurately. They hold the vial and syringe in place and give auditory clicks to count the correct dose. These products can be helpful if you also have problems with dexterity due to neuropathy in the hands or fingers. Additional information on dosing tools is available in Managing Your Diabetes, in the Medication Management section.
• Syringe magnifiers and needle guides are useful tools for people who are blind or low vision. They enlarge markings on the barrel of syringes and protect against unwanted needle sticks and bent needles.              
• Supply storage products are also available. There are cases and wallets for carrying preloaded syringes and insulin bottles in cool temperatures for travel or work. 

If you are struggling with the tasks of taking and organizing your medications because of vision loss, ask for help from your healthcare team and vision rehabilitation therapist. You can learn ways to make it easier using the right tools and techniques. Create a system that works for you so you can be independent when it comes to taking medications. 

Read More

• Resources to help you manage your medications with low or no vision – YouTube
• American Diabetes Association Healthy Living