Insulin Therapy Center

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.

Can young children benefit from a hybrid closed-loop insulin delivery system?

I had the pleasure of working with an elderly gentleman who was living alone. When he switched from insulin pens to a vial and syringe due to his insurance, his numbers started to increase into the 400’s and 500’s. He was feeling weak and lethargic but fortunately was able to pull …

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.

A new way to introduce multiple injections with the use of an insulin patch.

Training devices for autoinjectors can help ensure diabetes patients learn self-injection properly.

Half of those misdiagnosed were still being treated as though they had type 2 diabetes 13 years later.

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.

50-80% basal rate reduction lowers the risk of exercise-induced hypoglycemia.

Intensive insulin-adherence interventions that target type 2 diabetes patients with high risk of noncompliance can be beneficial.