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Ask the Right Questions

Jan 26, 2014

I do a lot of inpatient diabetes education. One of my patients was new to insulin and needed to go home on twice daily injections of 70/30. We educated her with all she needed to know to be successful at home. Two weeks after discharge the patient experienced a severe low requiring transport to our emergency dept. I went to see her in the ED. After asking about her insulin regime, we discovered that….

After asking about her insulin regime, we discovered that she was taking her 70/30 with all 3 meals. She said that since she was getting insulin with all 3 meals while in the hospital she thought she should continue to do the same at home. In the hospital she was on rapid acting insulin with meals and Lantus at night. She was taught 70/30 for ease and convenience at home. After some re-education, the patient left the ED understanding that her insulin injections will only be twice daily and has had no episodes of severe hypoglycemia since.

Lesson Learned:

When a patient’s blood sugars are not on target, the patient should be interviewed carefully with questions about the timing of their insulin injections.


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