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Family History Creates Insulin Confusion

Recently I saw a patient in his 70’s, with type 2 diabetes who had been on insulin for over 6 months. Family history revealed a son with type 1. The patient had been sent for diabetes education from a clinic where he was seen for dizziness and “just not feeling well.” The patient arrived with his granddaughter. He gave a good history of meals throughout the week, brought a well-kept log book, and had recorded his insulin doses, always around a meal but floated at different times and different doses.

When he spoke of his insulin he said “meal time” and the granddaughter agreed. When I had the patient demonstrate how he drew the insulin up with his bottle, bingo, the bottle was Lantus. Because the son was type 1 the patient thought he understood his diabetes. He did the best he could with the knowledge he had. We changed him over to a rapid acting insulin for meals and within one week the blood glucoses leveled out into a nice pattern.

Lesson Learned:

Never assume that the patient understood the directions that he may have received weeks or months ago. Always have the patient bring his medications to the office to review.

Patricia, RN, Diabetes Education

Copyright © 2013 Diabetes in Control, Inc. 

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