The Key to Asthma Care in Winter
With knowledge and preparation, asthma control does not have to worsen in the winter!
In Montana, our winters often entail cold temperatures and dry air. This may be a worrisome season for those with asthma. Cold temperatures and dry air are known triggers for causing asthma symptoms. In addition, a lot of respiratory illnesses circulate in the winter and some can lead to severe conditions, such as pneumonia. There are many actions patients with asthma can do to have the odds stacked in their favor!
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Lower your risk for an asthma flare-up
- Limit exposure to the outside cold air, if possible.
- When outside in cold air, make sure to bundle up and wear a scarf to slightly cover the nose and mouth.
- If the indoor environment is dry, make sure to utilize a humidifier. Humidify the air indoors to the level that makes your breathing most comfortable. Keep your home below 50% humidity.
- Take your asthma medications as prescribed! Those with poor asthma control are more likely to be affected by the cold dry air than those with good asthma control.
- Make sure to keep your medications or rescue inhaler with you at all times.
- Get immunized with the flu and the pneumonia, and COVID-19 vaccine to prevent and decrease severity of infection.
- For those that are 65 years and older the recommended flu vaccine is the high dose flu shot, such as the Fluzone High-Dose. For those that are 6 months and older, the CDC recommends getting a flu shot of the regular dose and schedule for that age group.
- For the pneumonia vaccination, adults 19-64 years old with asthma should receive either the Prevnar 20 (PCV20) or Vaxneuvance (PCV15) followed by a single dose of Pneumovax 23 (PPSV23) one year later.
- For the COVID-19 Vaccine, everyone five years and older is eligible for an updated bivalent vaccine as long as they are at least two months from their last COVID-19 vaccine. The bivalent vaccine covers the original virus and Omicron variant BA.4 and BA.5.
Pharmacist can help:
- Assess your patients with asthma by using the Asthma Control Test questionnaire to see how they are doing.
- If a patient is complaining of asthma symptoms due to the cold dry air, assess adherence and inhaler technique of the patient and provide easy solutions such as the above to see if these actions can help reduce their asthma flare-ups.
- Advocate for immunizations, such as the flu and pneumonia, and COVID-19, to asthma patients and counsel them on the importance of these vaccinations for their health.
Written by Xhea Meng Vang, Pharm D Candidate. Reviewed by Rachael Zins, PharmD, AE-C
Patient Driven Diabetes Management
People with diabetes should be able to make prudent and informed decisions about their diabetes every day. Those who attend a diabetes self-management program or who have access to a skilled diabetes care and education specialist are much better prepared to face the daily decisions associated with living with diabetes.
The food conundrum
Food and its relationship to glucose levels is often a mystery for people with diabetes. Personalized medical nutrition therapy is the gold standard for dietary lifestyle modification, however not all have access to this service. People on multiple daily insulin injections can manage postprandial glucose excursions with rapid acting insulin after learning the effects of carbohydrate on their glucose levels. For those using only basal insulin and/or oral agents the option is to regulate their food intake at each meal. The PDF study addressed this issue.
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Continuous glucose monitoring (CGM) allows patients to see the effects of food on glucose levels
The PDF Study was an open label randomized control trial of 126 patients with type 2 diabetes not using prandial insulin. The 12-week study used a simple and easily interpreted method called the SEOUL Algorithm, along with an intermittently scanned continuous glucose monitor (isCGM) to help people make food choices based on their postprandial glucose levels.
Characteristics of the study:
- Control group received:
- One session of general diabetes education
- A home blood glucose meter and supplies
- Instructions to check blood glucose twice daily
- Intervention group received:
Study Results
After the end of the study, the intervention group compared with the control group had a .5% reduction in A1c, 1.5 kg reduction in body weight, and a 16.5 mg/dL decrease in fasting blood glucose. This was accomplished with no changes in medication.
 The 3-Minuteextra Mile:
- Get to know the SEOUL algorithm and teach it to your diabetes patients.
- Encourage those using isCGM devices to scan pre and 1.5 to 2 hours post meal to learn about food choices.
- Promote the use of CGM in eligible patients.
James Bennett BsPharm, CDCES, BCGP
Bozeman MT 59715
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