I had a type 2 diabetic patient whose fasting blood sugars were all over the place. The patient was on 34 units of Lantus that she stated she took every night. After asking more questions I realized that on the patient's prescription for Lantus, it read, "Take 34 units every night before bed."...
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However, this patient was retired and did not follow any regular schedule. One night she might go to bed at 11 pm and the next night she might stay up on the computer until 4 am. She would always just take her Lantus before she went to bed.
When I explained to her how Lantus worked and that it stayed in her for up to 24 hours, we decided she would take her Lantus shot every night after the 10 pm news.
Her blood sugars were much more consistent after that.
Lesson Learned:
Never assume anything when it comes to insulin use. Ask specific questions such as to time of injection, dosage, etc… and also ask patients to demonstrate their injection techniques.
Kate Blumberg, LDN, RD, CDE
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