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Insulin Therapy Center

Insulin Therapy for Diabetes: Diabetes in Control answers key questions about the uses and challenges of insulin in diabetes management, including:
– How insulin is used to treat diabetes
– How/when a healthcare professional should consider insulin therapy for diabetes patients
– What a healthcare professional needs to know about making insulin therapy safe and effective

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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Pump Setting Changes May Go Unnoticed

Recently a pump user reported a sudden increase in her glucose levels lasting a couple of days. Her blood sugars were elevated to 275-320mg/dL, with no ketones present.  Changing her infusion sets did not help. Nor did rotating to a new injection site or even using a fresh vial of insulin. After reviewing her insulin pump we noticed a symbol on her “home screen” saying that a special feature was running.

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