Recently, I saw a patient who was a seasoned insulin user.
He was on Lantus at bedtime, and a fixed dose of regular insulin before each meal. This was his first visit with a CDE, and he complained of hypoglycemic episodes before breakfast. I reviewed his insulin dosages, techniques and A1c levels with him. Everything seemed okay until I asked him the exact time of the insulin shots.
He was giving himself the regular insulin at 12 midnight, before a snack, not before his dinner meal. After we changed his timing so he corrected with regular insulin before his dinner meal, his next group of morning fasting log book readings were well within desired range with no further complaints of hypoglycemic episodes.
Never take for granted that patients are dosing at the correct times. Asking questions and having them demonstrate techniques can prevent serious problems.
Report Medication Errors to ISMP:
Diabetes in Control is partnered with the Institute for Safe Medication Practices (ISMP) to help ensure errors and near-miss events get reported and shared with millions of health care practitioners. The ISMP is a Patient Safety Organization obligated by law to maintain the anonymity of anyone involved, as well as omitting or changing contextual details for that purpose. Help save lives and protect patients and colleagues by confidentially reporting errors to the ISMP.
And if you have a “Diabetes Disaster Averted” story, please also send it in separately to Diabetes In Control. If we use it you will receive a Visa Gift Card worth $50.00. Click here to let us know the details. (You can use your name or remain anonymous if you prefer.) Please note that ISMP is not associated with this Gift Card promotion.
Copyright © 2012 Diabetes In Control, Inc.
|←Previous Diabetes Disaster Averted
Insulin and Extremes in Temperature
Next Diabetes Disaster Averted →