Thursday , December 14 2017
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Insulin Timing and Hypoglycemia

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.

Lesson Learned:

Never take for granted that patients are dosing at the correct times. Asking questions and having them demonstrate techniques can prevent serious problems.

Anonymous

 

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