Meera Ruparelia - Pharmacist and Diabetes Educator

06/05/2024

Medication Mondays 💊💉

**REMINDER**

An up-to-date medicines list and health profile is as important as a passport or a will!

Do you keep an updated list in your wallet or handbag?

There is nothing worse than being admitted to hospital or seeing a specialist and the treating team having little to no information about your health background.

29/04/2024

Medication Mondays 💊💉

Insulin is a high-risk medication (amongst others) - these are medications that have a high potential to cause harm should they be used incorrectly.

There are over 15 different types of insulin products available on the Australian market (various combinations, action profiles, devices - vial vs penfill vs disposable pen). You can see how quickly this can get so confusing.

Lets take insulin aspart as an example (refer to image attached)
All insulin aspart products in Australia are the same strength: 100units/ml, including Novorapid and the faster-acting Fiasp.
If the only information on a script is insulin aspart 100units/ml, it would be very hard to decipher which of the 6 insulin aspart products is the correct one.

To avoid errors and to prescribe insulin safely, along with the active ingredient/name of the insulin, your prescriber should always specify:

1. Brand name of the insulin E.g. Novorapid or Fiasp
2. Strength with "units" written in full rather than "u" E.g. 100 units per 1mL
3. Formulation E.g. Flexpen or Vial or Penfill or Cartridge
4. Route E.g. Subcutaneous injection or via insulin pump
5. Dose with units in full E.g. 5units (not applicable if being used in a pump)
6. Frequency and timing of the dose E.g. Inject 5 units with meals three times a day (not applicable if being used in a pump)

It is so important for anyone taking insulin to be aware of this, allowing you to confidently advocate for yourself.

More info available here:

https://www.safetyandquality.gov.au/sites/default/files/2022-11/safer_insulin_prescribing_-_guidance_for_australian_prescribers.pdf

22/04/2024

A couple of weeks ago I wore a Libre Continuous Glucose Monitor to see how different foods impact my blood glucose level. This is a little device that sits just under the skin and monitors blood glucose levels continually. I don't have diabetes, so it was very interesting to see the result.

Here is an example of a surprising one for me - this was my BGL 2 hours after a medium-sized portion of a "dhosa" (Indian savoury crepe made of rice and lentils) and chai latte. A good reminder that even people who don't have diabetes have peaks in blood glucose levels.

15/04/2024

Medication Mondays 💊💉

Did you know not all medicines in Australia are tested for their effectiveness? And there's an easy way for you to check by looking at the box/bottle!

All medicines and medical devices are regulated by the TGA (Therapeutics Goods Administration) in Australia and given either an AUST R or AUST L number.

Medicines that have an AUST R number are registered and thoroughly assessed for quality, safety AND efficacy (ie the medicine can do what it says it will). This mainly includes high risk medications such as all prescription medicines, most over-the-counter medicines and some complementary/herbal medicines that have enough evidence to support the claims they make eg Vitamin D

Medicines that have an AUST L number are generally lower risk and only tested for quality and safety, NOT efficacy - the supplier is supposed to have evidence to substantiate any claims they make should they be audited, however, this isn't actually assessed to obtain a listing. This generally includes complementary or herbal medicines

Next time you pick up your medicines, especially if they are non-prescription medicines, look out for the AUST number.

Further information can be found here: https://www.tga.gov.au/resources/resource/guidance/how-we-regulate-medicines
https://australianprescriber.tg.org.au/articles/what-does-tga-approval-of-medicines-mean.html

08/04/2024

Medication Mondays 💊💉

So many medicines are affected by the food we eat resulting in an increase or decrease in medication effect or exacerbation of side effects.

For example, eating green vegetables with certain blood thinners could decrease their effectiveness (excuse for some to avoid their greens?! :P)

It is always a good idea to check if your medications have any major drug-food interactions!

03/04/2024

Just watched "The Ozempic undergoround" on ABC released earlier this week.

There are many websites/companies claiming to be able to supply compounded Ozempic (semaglutide) given the ongoing shortage.

A good reminder that compounded pharmaceuticals are not well regulated. If there's an online "pharmaceutical company" selling "Ozempic (semaglutide)", it probably isn't actually Ozempic, especially if there are clear red flags ie supplying without a prescription.

Full episode can be watched here: https://www.youtube.com/watch?v=A6W57r1yTWs
Written version here: https://www.abc.net.au/news/2024-04-01/cowboy-pharmacist-behind-a-replica-ozempic-and-mounjaro-scam/103644794

Ozempic and Mounjaro are the semaglutide weight-loss wonder drugs in high demand and short supply. Some pharmacists think making their own versions of the in...

01/04/2024

Medication Mondays💊💉

Insulin can be expensive.

We are so lucky in Australia to have a system that subsidises our medicines and CGM devices! It's not perfect but it could have been worse...

20/03/2024

Hello there!
Welcome and thank you for visiting my page.

I'm a Clinical Pharmacist and Diabetes Educator with over 12 years of clinical experience as a hospital pharmacist. In 2022, my husband was diagnosed with Type 1 diabetes and this began my journey towards becoming a diabetes educator.

I provide medication reviews for all patients, including those with complex medical backgrounds, with a specific interest in type 1 diabetes and type 2 diabetes requiring insulin. More info here: https://www.type1familycentre.org.au/medication-reviews

Appointments can be conducted in English, Gujarati or Hindi in person from the Type 1 Diabetes Family Centre in Stirling WA or online via Telehealth.
Bookings can be made via: https://www.sugarsafe.com.au/book-appointment or by calling 08 9446 6446.

I am passionate about helping people living with diabetes and look forward to being a part of your journey.