Tuesday , November 21 2017
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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, stating her dog wakes her up if and when she has hypoglycemia. She called to let us know her dog passed away.

There are some mornings she realizes she must have been low during the night because her sheets are wet from perspiration, and she remembers having had vivid dreams. She wants to know what she can do. Although we have tweaked her plan, she continues to have these unexpected events about once a week. Besides the readjustments, we once again recommended CGM. She once again refused, therefore we recommended she get another dog, which she did.

She called us a month later to let us know how well she, her husband, and her new dog are getting along. Her new dog is now waking her up by licking her face when her glucose levels are falling. She is able to wake up and treat her low. She’s so pleased and thanked us.

Lessons Learned:

  • Sometimes you and your patients do all you know and is recommended to prevent hypo- and hyperglycemic events, but they may continue to occur.
  • Not all patients agree with their health care professionals’ recommendations.
  • Work with patients to design an individualized plan for each patient.