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I’m Taking Insulin, Now What?

 

Review By: Pamela Grimberg, University of Florida College of Pharmacy Doctorial Candidate
 
Dave Joffe, BSPharm, CDE, FACA
 

This book, written by Andrew S. Rhinehart, is a great reference book for Type 1 or Type 2 diabetic patients who need insulin therapy to maintain good glycemic control. Dr. Rhinehart describes how some patients are told to start insulin by their doctor, and given a prescription, without the chance to ask questions or receive education about their current physiological status. This book does a great job of incorporating the basics of insulin therapy for all types of diabetes patients.

The opening chapters address some commonly asked questions and concerns by patients who have recently been prescribed insulin. This includes letting the reader know that because they have to go on insulin, it is not a punishment for bad behavior. It discusses the difference between types of insulin and associates it with excellent examples. This background information includes various options for injecting insulin, and provides common side effects associated with therapy.

The second part of the book describes the importance of basal and bolus therapy. It elucidates how a pancreas works in people who do not have diabetes and compares it to the goals of patients that have diabetes. This information is reinforced with a visual graph of basal and bolus daily insulin levels and examples of the amount of insulin units needed based on food consumption. Dr. Rhinehart also describes how to prepare insulin using a vial and syringe, and insulin pen, in a step-by-step approach. It includes information such as the suggested places to inject daily insulin doses, and the benefits and disadvantages of each spot. Hints are included to help the reader when the injections don’t always happen the way they should.

In the final chapters, glucose monitoring, exercise, and dietary modifications that might be beneficial to patients that are new to using insulin, are discussed. The author empathizes with the fears of having a hypoglycemic episode and even recommends products to carry in an emergency pack to better relieve anxiety. Information is provided about other injectable medications such as Byetta and Symlin, and their mechanisms of action and side effects.

Overall, this was an educational book describing the importance of insulin to diabetic patients who are in need of valuable information. It provides illustrative examples that will connect with patients of all ages. I would recommend it to anyone who would like a better understanding of what it means to use insulin to control their diabetes. 


Dr. Rhinehart serves as the Diabetologist and Medical Director of the Johnston Memorial Diabetes Care Center in Abingdon, VA where he has been in practice since finishing his medical training in 1995. His vision of a comprehensive Diabetes Care Center was realized in 2008; at the center the patient’s Diabetes Care Team is “preassembled” where he, the certified diabetes educators, and other specialists work together to achieve the various treatment goals discussed in “I Have Diabetes!! Now What?” Dr. Rhinehart has been awarded recognition from the American Diabetes Association (ADA) and the National Committee for Quality Assurance (NCQA) Diabetes Physician Recognition program for providing high quality care to individuals with diabetes since 2002. At Johnston Memorial Diabetes Care Center he serves as the Diabetologist and Medical Director. The Diabetes Care Center allows patients to receive the diabetes management in one location where the care providers come together as a team to assist patients in meeting their treatment goals. Dr. Rhinehart is a member of the Professional Section of the American Diabetes Association and frequently lectures to patients and providers regarding diabetes and its related conditions. He is also a member of the Virginia Diabetes Council.