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Diabetes In Control

Diabetes In Control

Managing Weight-Loss Insulin Changes

I recently started working with a 58 y/o gentleman who had insulin dependent type 2 diabetes. He was 110 pounds overweight, and was using 120 units of Lantus and 30 units of Humalog daily. His most recent A1c was 8.6. The program he was placed on involved drinking a medical liquid food supplement 5 times a day which contains 12 grams of carbs per serving plus a meal that consisted of a small amount of protein and vegetables.

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Calibrating Correctly

A VA Pharmacist received an order for 40 units of U-500 insulin and questioned its validity. The actual dose desired by the physician was 200 units. The physician indicated the 40 units reflected the mark on a U 100 syringe to which the patient was to draw back the plunger.  This was found to be a common practice so the VA developed a system requirement which required physicians to indicate the total units/mls (Example: 200 units/.4ml) for U 500. Insulin must be in the chart and syringes calibrated in mls must be used.

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Excessive Needle Bruising Conundrum

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A physician asked me to see his patient, a middle-aged woman who was using an insulin pen.  She had extensive bruising at her injection sites, with no simple explanation.  She was not taking any medications associated with increased bleeding, and did not bruise easily otherwise. The physician wondered if there was something else about her injection technique that produced the bruising.

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Pharmacist’s Diligence Saves Patient’s Health and Money

I am a retail pharmacist working in a busy chain pharmacy.  A patient came in and requested a temporary supply of his Crestor 40 mg tablets because he had run out of tablets before he was eligible for a refill through insurance.  I checked his profile and noticed that it had been 1 1/2 months since his last 90 day refill so I asked why he had run out.  He said that his doctor had told him to double up and take 80 mg daily.  This didn't sound correct, but it was after office hours and the patient was adamant that these were his doctor's instructions and that he would have to stop his medication if I didn't dispense to him. 

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