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Disasters Averted

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Patient Errors

Include Caretakers in Diabetes Patients' Plans to Lower A1c

A married male patient, 68 years of age, has been prescribed long-acting insulin twice a day because once-daily does not work 24 hours for him, and his dose is large. Therefore breaking it into two smaller injections helps bring down his glucose,...

Preparation for Unexpected Events Should Include Finances

It was a beautiful day. A patient of mine who has type 1 and her friends who do not have diabetes decided at the last minute to go out and enjoy it. They walked and walked, ate out for lunch, and walked and walked some more. She walked a lot more...

Diabetes Care and Education Beyond the Clinical Practice Setting

Years ago I was attending an annual AADE meeting in Washington, DC. It was a hot summer day in August and while running between meetings, I got overheated. One of my fellow attendees, a nurse educator who was also a friend and past president of...

Even Experienced Patients Need Reviews of Insulin Injection Technique

A patient came to us on reasonably high doses of basal bolus insulin, using Levemir and NovoLog flex pens. He stated that he had been using insulin for a few months and was referred for more management assistance from his provider. He was seen by...

Exercise Not Guaranteed to Lower Blood Glucose

John, a gentleman in his 70's who has diabetes, always visited my group after he exercised.

Treat the Whole Patient, Not Just Part

We were running a clinical study on erectile dysfunction.

Hypoglycemia Can Impact Job Performance

A 55-year-old woman with type 2 diabetes who was being treated with glimiperide had had a difficult time finding a job.

Using Pens - Keep It In and Hold It Down!

Susan received a phone call from her clinician's office recommending that she start using a pen for her insulin.

Dealing with Difficult Patients

Ricardo, a 35-year-old man newly diagnosed with type 1 diabetes, was hospitalized for diabetic ketoacidosis (DKA).

Not All Insulin Pens are the Same

Recently, a patient of mine called about her post-meal glucose levels which were increasing.

Assessing Insulin Administration Technique

An 83-year-old woman who lived alone and was very active in her community was having wide swings in her glucose levels.

Remote Wireless Monitoring Can Help Patients Newly Diagnosed with T1

A patient of mine was newly diagnosed with type 1 diabetes. 

What's Hiding in that Insulin Box?

Last week in the pharmacy we received an electronic refill authorization for regular and nph insulin.

Treatment Errors

Customer Service Goes Beyond Prescription Delivery

A woman, 59 years of age, was diagnosed with diabetes while in the hospital. She was discharged on basal bolus insulin. The diabetes educator (CDE) was contacted to teach insulin administration via insulin pens upon discharge. The patient was...

Misunderstanding Basal Insulin Requirements Can Be Deadly

In an inpatient setting, a type 1 diabetes patient was scheduled for surgery the next morning. The patient was to be NPO after midnight and so the RN on duty withheld the patient's Lantus. The patient's glucose crept up, but this was not...

When Patients' Symptoms Don't Fit the Diagnosis, Look Deeper

A young man, 32 years of age, with a history of ADHD and being treated with Adderall, was diagnosed with type 2 diabetes. He had symptoms upon diagnosis -- frequent urination, weight loss, and his BMI was 20. He followed a low carb diet, was taking...

Hypoglycemia Can Impact Job Performance

A 55-year-old woman with type 2 diabetes who was being treated with glimiperide had had a difficult time finding a job.

Test Insulin Techniques of New Caregivers

The patient is a 91-year-old female with a 10-year history of type 2 diabetes.

Additional Disasters Averted

Old Shoes Best Fit When New Shoes Bring New Problems

Two weeks ago, a patient came in to the pharmacy complaining that his feet were burning and sore, and he was developing blisters on the top of his left foot. The patient had diabetes for about 13 years and had recently been running an A1c of 7.9....

Once Informed, Many Patients Know Best

Female, 24 years of age, type 2 diabetes and obesity, wants better glucose management and to lose weight. Most of her meals consist of high carb, fast food take out, she skips breakfast and overeats during the evening hours. She has a sedentary...

Case Study: The Importance of Patient-Centered Therapy

A 59 YOF is recently discharged from hospital after an allergic reaction to an anesthesia induction agent. She was placed on high-dose steroid for the reaction while she was in the hospital. Patient had completed her steroid tapering dose 2...

Best Plan for Patient May Not Be The Recommended Plan

Female, type 1 diabetes for 42 years, 58 years of age, lives with husband and dog. Patient has hypoglycemic unawareness. We regularly readjust her treatment plan and have recommended CGM for this patient on numerous occasions, but she refuses,...

Sudden Weight Loss May Not Just Be Due to Patient's Healthier Habits

A patient, 62 years of age, with type 2 diabetes, obese and with an intellectual disability disorder had been a patient at our clinic for over 10 years. Treatment included metformin and insulin. He met regularly with his endocrinologist and...

Newly Diagnosed Patients Can Be Easily Overwhelmed

A female patient, 68 years of age, newly diagnosed with type 2 diabetes had her initial visit with her endocrinologist and diabetes educator. Her second visit was then scheduled for two weeks later. However, the patient was a no-show for her second...

Excessive Bleeding after Injection Raises Suspicions

A man 79 years of age was referred to me to start insulin. As a diabetes educator, I don't always have a full history and comprehensive labs given to me from the PCP. I met the patient and his family who told me his history, medications, lifestyle,...

When Diabetes Gets Out of Control, Get Back to the Basics

A female chef, 28 years of age with type 1 diabetes over 18 years, reported extreme glucose excursions. She had pretty good control up until she took on this profession....

Traveling by Air with Diabetes

When traveling, "nearby" may mean closer than you think. A patient of mine, 35 years of age, with type 1 diabetes, boarded a plane. As recommended, she took her supplies, food, and treatment for a low with her in her carry-on bag....

New GLP-1 Medication: Starting Low and Going Slow

Nausea is a common side effect of GLP-1 therapy. Recently a few of my patients took the recommended low starting dose, but got so nauseated they refused treatment beyond that. From this, I've learned to start my patients on half the low dose of the...

Dental Care Can Be an Important Diabetes Management Tool

A female patient on insulin, 67 years of age, required more and more insulin to manage her glucose levels. She was eating healthily, exercising, monitoring, and taking her insulin as prescribed. I asked her when she had last seen her dentist. She...

Patient's Plan to "Stop All of My Medicine" Not a Good Idea...

The patient, a woman, 52 years of age, has type 2 diabetes and is on metformin, a GLP-1 agonist, and a long-acting insulin. Over the past few months, I've received calls and emails from her every now and then to let me know her glucose levels were...

Asking the Question: "Are You Wearing Your CPAP?"

A male patient, 56 years of age, with type 2 diabetes, hypertension, congestive heart failure, and sleep apnea visited. We hadn't seen him for 6 months. His blood pressure was up, in the 140-160/90–102 range, glucose levels were higher than...

SGLT-2 Inhibitors: Teach from the Start and Manage Expectations

A female patient, 42 years of age, with type 2 diabetes, is overweight with a history of vaginal yeast infections with elevated glucose levels. Wanting to better manage her diabetes and lose some weight, the commercials about SGLT-2 inhibitors...

Insulin Before Exercise May Be Needed to Lower Morning Highs

A man with type 1 diabetes started an exercise program to help him manage his early morning highs. He exercised every evening, at which time his glucose levels would drop during and after exercise. Thinking that exercise would lower his early...

Patient's Renewed Commitment to Low BG's Leads to "Keytones" Clarity

I recently received a text message from a type 1 patient who has been wearing a pump over 10 years.

Long-Term Follow Up Key to Keeping Patients on Track

A new patient of mine was diagnosed with type 2 diabetes and obesity. We discussed a weight loss treatment to target both her diabetes and obesity, and she followed our mutually agreed upon treatment plan. Things were going well -- she would visit...

Helping Your Patients Choose Alternate Testing Sites Wisely

About one and a half years ago I was evaluating the educational needs of a mid-30's, female, hospital in-patient with diabetes mellitus type 2 (DM2).

Diabetes Misinformation Can Delay Treatment, Advance Complications

Can we "prevent" diabetes with weight loss? Or would it be better to say we can "delay" diabetes with healthy behavior?

Change Language to Combat Feelings of Failure

A patient presented for outpatient diabetes education stating, "I really don't know why I am here. I know I need to lose weight. I don't know what else you can tell me."

CGM Best Fit for Active Type 1 Patients

Janelle, an RN, is 36 years old with type 1 diabetes.

Custom Molded Shoes: If the Shoe Doesn't Fit...

A patient of mine who had diabetes and peripheral neuropathy came home from the hospital after a below-the-knee amputation of her right leg.

New FlexTouch Pens Not the Same as the Old

I was reviewing a client's insulin administration.

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239 Total articles for Disasters Averted

Browse our other news categories below.
A. Lee Dellon, MD | Aaron I. Vinik, MD, PhD, FCP, MACP | Beverly Price | Charles W Martin, DD | Derek Lowe, PhD | Dr. Brian Jakes, Jr. | Dr. Fred Pescatore | Dr. Tom Burke, Ph.D | Eric S. Freedland | Evan D. Rosen | Ginger Kanzer-Lewis | Greg Milliger | Kristina Sandstedt | Laura Plunkett | Leonard Lipson, M.A. | Louis H. Philipson | Maria Emanuel Ryan, DDS, PhD | Marilyn Porter, RD, CDE | Melissa Diane Smith | Michael R. Cohen, RPh, MS, ScD, FASHP | Paul Chous, M.A., OD | Philip A. Wood PhD | R. Keith Campbell, Professor, B.Pharm, MBA, CDE | Richard K. Bernstein, MD | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

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CME/CE of the Week
Lois Exelbert,

Category: Nursing
Credits: 1