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Disasters Averted

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Report Medication Errors to ISMP:

Diabetes in Control is partnered with the Institute for Safe Medication Practices (ISMP) to help ensure errors and near-miss events get reported and shared with millions of health care practitioners. The ISMP is a Patient Safety Organization obligated by law to maintain the anonymity of anyone involved, as well as omitting or changing contextual details for that purpose. Help save lives and protect patients and colleagues by confidentially reporting errors to the ISMP.

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Prescription Errors

NovoLog Mix 70/30 Confusion

When prescribing NovoLog® Mix 70/30 analog insulin, health care professionals may write an unclear prescription, or if using an EMR system, inadvertently select Novolin® 70/30 human insulin instead. Be on the lookout...


Dosing Error Due to Accent Misinterpretation

When reviewing the medical record of a hospital patient prior to meeting with her for a diabetes consult, I noted that the doctor had ordered 46 units of Lantus to be given daily at bedtime. When I went in to visit with the patient, she had a very...


Improving Patient Safety and Reducing Medical Errors in Diabetes Care

Steve Freed, Publisher, Diabetes In Control Errors in diabetes care are a common cause of complications and can result in disability and even death. The diabetes errors being reported are...


High-alert Medications Lists

From the Institute for Safe Medication Practices (ISMP): High-alert medications are drugs that bear a heightened risk of causing significant patient harm when used in error. Although mistakes may or may not be more common with these drugs,...


Fulfillment Errors

NovoLog Mix 70/30 Confusion

When prescribing NovoLog® Mix 70/30 analog insulin, health care professionals may write an unclear prescription, or if using an EMR system, inadvertently select Novolin® 70/30 human insulin instead. Be on the lookout...


Improving Patient Safety and Reducing Medical Errors in Diabetes Care

Steve Freed, Publisher, Diabetes In Control Errors in diabetes care are a common cause of complications and can result in disability and even death. The diabetes errors being reported are...


High-alert Medications Lists

From the Institute for Safe Medication Practices (ISMP): High-alert medications are drugs that bear a heightened risk of causing significant patient harm when used in error. Although mistakes may or may not be more common with these drugs,...


Patient Errors

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. I noticed he always had something (hard candy) in his mouth and he seemed tired. I asked him why he was doing this candy thing. He said, "After exercise...


Treat the Whole Patient, Not Just Part

We were running a clinical study on erectile dysfunction. An obese 68-year-old male came in looking for help for his ED, so he thought he might qualify for the study. He had not had a medical workup for some time and wasn't aware of any underlying...


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. She was finally hired into a law firm as a legal secretary. She would be frequently called into meetings at the last minute,...


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. She had also been prescribed a GLP-1 receptor agonist and was to go to the pharmacy to pick them up. She went and signed up for...


Dealing with Difficult Patients

Ricardo, a 35-year-old man newly diagnosed with type 1 diabetes, was hospitalized for diabetic ketoacidosis (DKA). Once he was stabilized, he wanted to go home. He refused to learn how to self-administer insulin. However, he was told he would not...


Not All Insulin Pens are the Same

Recently, a patient of mine called about her post-meal glucose levels which were increasing. She had not made any changes to food choices, there were no health changes, and so my first thought was that her insulin was bad. I had the patient get a...


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. She reported sometimes waking up hours after dinner with her head in her dinner plate. She did not understand why. She...


Remote Wireless Monitoring Can Help Patients Newly Diagnosed with T1

A patient of mine was newly diagnosed with type 1 diabetes. He started on insulin and I taught him about


What's Hiding in that Insulin Box?

Last week in the pharmacy we received an electronic refill authorization for regular and nph insulin. The patient had been using the two insulins together for about two years and seemed to be in relatively good control. The refills had the sig code...


"Do Not Crush, Chew or Cut"

From the Institute for Safe Medication Practices (ISMP): When a patient is prescribed a timed release medication such...


Diabetes and Tattoos: Case Study and Guidance

A 29-year-old woman with insulin-dependent diabetes noted a painful erosion at the site of the tattoo which she had gotten 7 days before. A culture isolated staphylococcus aureus confirming the clinical impression of staph. This...


Treatment Errors

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. She was finally hired into a law firm as a legal secretary. She would be frequently called into meetings at the last minute,...


Test Insulin Techniques of New Caregivers

The patient is a 91-year-old female with a 10-year history of type 2 diabetes. Two years ago, despite use of multiple oral hypoglycemic agents, her glycated hemoglobin (HbA1c) remained at 9.2% (77 mmol/mol) and her home glucose levels were in the...


Glucagon Label Contributes to Confusion

From our partners at the Institute for Safe Medication Practices (ISMP.org): A nurse gave orange juice to a patient with a blood glucose level of less than 50 mg/dL, but it did not raise the glucose level much, so he administered a dose of...


NovoLog Mix 70/30 Confusion

When prescribing NovoLog® Mix 70/30 analog insulin, health care professionals may write an unclear prescription, or if using an EMR system, inadvertently select Novolin® 70/30 human insulin instead. Be on the lookout...


Hemoglobin Abnormalities and A1c Testing

I recently saw a patient for a diabetes follow-up and had just gotten her lab values faxed over. Her A1c came back at 9.6 despite the patient telling me that her glucose meter readings were much lower. She even showed me...


Dosing Error Due to Accent Misinterpretation

When reviewing the medical record of a hospital patient prior to meeting with her for a diabetes consult, I noted that the doctor had ordered 46 units of Lantus to be given daily at bedtime. When I went in to visit with the patient, she had a very...


Improving Patient Safety and Reducing Medical Errors in Diabetes Care

Steve Freed, Publisher, Diabetes In Control Errors in diabetes care are a common cause of complications and can result in disability and even death. The diabetes errors being reported are...


High-alert Medications Lists

From the Institute for Safe Medication Practices (ISMP): High-alert medications are drugs that bear a heightened risk of causing significant patient harm when used in error. Although mistakes may or may not be more common with these drugs,...


Additional Disasters Averted

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). She and her husband both had DM2. Both were slender, active, did carb counting and followed all...


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? Often people are reluctant to admit that they have diabetes or to initiate treatment. Many times...


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." She was reassured when I told her that there are people who are a...


CGM Best Fit for Active Type 1 Patients

Janelle, an RN, is 36 years old with type 1 diabetes. She has a busy life between family and work. She eats healthy, exercises regularly, and wears a pump but occasionally has severe hypoglycemia, especially during exercise and at...


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. She lived alone and was housebound. Having lost one leg, I knew she was at increased risk for losing her...


New FlexTouch Pens Not the Same as the Old

I was reviewing a client's insulin administration. She was administering Levemir (insulin detemir), 60 units, with a FlexPen. She said that she just dialed the dose to the maximum it would allow her as she knew it only would dial to 60...


IDF Diabetes Atlas - North America and Caribbean


IDF Diabetes Atlas - Africa


IDF Diabetes Atlas - Europe

Diabetes is a huge and growing...


IDF Diabetes Atlas - Southeast Asia

Diabetes is a huge and growing...


IDF Diabetes Atlas - Middle East and North Africa

Diabetes is a...


IDF Diabetes Atlas - Western Pacific

Diabetes is a huge and growing...


IDF Diabetes Atlas - South and Central America

Diabetes is a huge...


All Insulins Not the Same

I recently had a home care patient who had been discharged from a skilled nursing facility with a prescription for regular insulin, and who was put on a sliding scale dosage. The patient was experiencing hypoglycemic reactions. I was called to...


Patient's Method of Figuring Meal-time Insulin Doesn't Quite Work

Recently I assessed an 84 year old inpatient with diabetes for his insulin usage at home. In reporting his dosing he stated that after he checked his glucose before each meal he took the "first two numbers of the...


Is It Sugar-Free or Isn’t It?

One of my long term patients called my office because she could not figure out what was happening with her post breakfast glucose readings. She counted carbs and would typically have a 2 hour ppg of no more than 145 mg/dl but even though her...



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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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