A 15-year-old type 1 diabetic is seen who frequently forgets to take her insulin because of time issues. At the time of her initial appointment, her A1C was 10.4. After discussing issues preventing her from taking her insulin, I suggested that she take her insulin through her clothes. After my suggestion, another healthcare professional told her she could not inject through her clothes, but she listened to my advice and did so. Thirty days (30) later pt has a 0.5 reduction in her A1C.
- You meet the pt where they are. It the pt is going to miss dosing because of the time it takes to inject, injection through the clothes is an option.
- Be knowledgeable – ensure you are on firm footing when you advise a pt to do something that may be considered unorthodox by others. I had attended a presentation at AADE that discussed injecting insulin through clothes if needed, which helped me back up my suggestion.
- Don’t throw out the baby in the bath water. Holding on to what “we once thought” can keep us from optimizing success for our patients.
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