Letter from the Editor: Diabetes Disaster Avoided!

It seems like every time we get something new we forget about the old. Just last week I got a frantic call from an experienced, well-controlled, Omnipod patient who had not replaced her pod and had to inject insulin with a syringe. She was at lunch with friends and had calculated that her dose was 7 units for her glucose and meal. She took out a 3/10cc syringe and because it was only a third as big, somehow ended up giving herself 60 units of insulin 20 minutes before she called me. She figured that if she drank a big glass of OJ with sugar in it, all would be okay. After looking at her carb ratio we figured it would take 900 carbs to cover the insulin, and the 60 units could lower her glucose 3000 mg/dl. With this in mind I had her consume the OJ with 10 packs of sugar dissolved in it, and sent her to the closest ER, which I called to make them aware of the situation. Good thing I did because when she got to the hospital her glucose was 341 and they would have been concerned about the high rather than the low. Fortunately they immediately started her on D50 and 2 hours later her glucose was 215mg/dl. They kept her there for a few more hours and finally were able to stop the drip after 4.5 hours and her glucose leveled at 147mg/dl. DIABETES DISASTER AVOIDED!

My intern was with me and when I got off the phone he was looking at me in dismay. I asked him what was wrong and he said, "They told us in school that insulin is the most error prone drug but I never had actually seen what to do about it."

In the next few weeks, we will begin a new feature focused on diabetes disasters and how many of you have avoided them. Share your stories about diabetes care disasters prevented or corrected and help spread the word about "near-misses" that will help us all avoid needless tragedies. Click here to let us know the details. (You can use your name or remain anonymous if you prefer.) Thank you!

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In 1970, the group Five Man Electrical Band released the hit single, "Signs," and in it there is a line, "Do This, Don’t Do That, Can’t You Read The Sign?" This week, Dr. Jen Nash, Clinical Psychologist, with PositiveDiabetes.com, helps us to understand why getting your patients to do what you want is so hard and why Motivational Interviewing (MI) might be the answer.

Announcements:

TCOYD Conference and Health Fair, Saturday, September 11, 2010, Providence, Rhode Island 
The TCOYD team will be at the Rhode Island Convention Center in Providence, RI, on Saturday, September 11, for a full day of panel discussions, health exhibits, workshops, physical acitivies and hands-on sessions. Special Guests include: Charlie Kimball (Indy Lights Race Car driver) and Kim Lyons (Fitness Expert, Professional Trainer and Certified Nutritionist). For more 2010 upcoming conference details, please go to TCOYD.org.

dLife.com: August 22, 7PM ET on CNBC
Topics:  Leading doctors debate different paths to better blood sugar control; dLife’s first community exercise class for people with diabetes; and a comfort food classic in the dLife kitchen. Special Guest: Dr. Richard Bernstein. Sundays on CNBC at 7 PM ET, 6 PM CT, and 4 PM PT. Catch up on dLife.com.

Please answer this week's Poll question (in the right-hand column):

What percentage of doctors explain to their patients what the A1c result means?

This week "Test Your Diabetes Knowledge" with the Nutrition by the Numbers Quiz!

Dave Joffe, Editor-in-chief