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Disasters Averted

Disasters Averted are stories submitted by our readers and medical editors from direct experience in the field. Do you have a story? If your story is used, we will send you a $25 Amazon Gift Card! Submissions can be anonymous.

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There Is A Difference

Syringe for insulin

57-year-old female, prediabetes, class II obesity, arthritis R knee, family history includes father with type 2 diabetes with renal disease. Verbalizes her fear of having diabetes. Besides discussing lower carbohydrate meal plan, discussed metformin, and being as active as she possibly can without causing further injury to her knee. First set of labs showed her A1C to be 6.4% and her FPG 118.

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It’s Allergy Season

Dandelion silhouette against sunset

Female, 58 years of age, type 2 diabetes, obesity, taking (Qsymia- phentermine/topamax) for weight loss, antihypertensive for hypertension, and metformin for glucose management. Blood pressure usually in the 120-130/70-80 range, glucose averages ~120, and was losing weight. Today’s b/p 170/90, random glucose 232, c/o tinnitus. Weight was up 5 pounds since last seen 3 months ago. It’s now allergy season. After further discussion, she told me she was started on a medrol dosepak, and on her own purchased and is taking an OTC allergy medication.

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The Benefits of Motivational Interviewing

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Woman, 57 years of age, prediabetes, hyperlipidemia, class I obesity and history of gestational diabetes. I’ve been working with her for the past two years. The first year she was very motivated because of her new diagnosis of prediabetes and her weight being what it was. Her son was getting married and she wanted to lose weight for the wedding. We discussed a plan for her.

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When Changing to Combo Pill, Know the Dosages You are Changing

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Woman, 62 years of age, musician, travels often, type 2 diabetes, obesity, hyperlipidemia, fatty liver. Was traveling for two months straight on the road. Late nights/parties and a lot of drinking. Admitted not having taken her GLP-1 or really following any meal or healthy life plan/schedule she was following before leaving. Since last office visit 3 months ago, weight up 10 pounds, fasting glucose 170 in office.

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Non-Compliant No More!

Patient and doctor

A patient, 48 years of age, female, type 2 diabetes and obese, was referred to me for diabetes and weight management. Her first visit was 8 a.m., after fasting for 10 hours. Her A1c was 7.4%, BMI 37, BP 164/92, HR 92. The previous hcp had recorded she was recommended a low carb diet and the following medications: Metformin, 1,000mg twice daily; Byetta 10mcg sq twice daily. It was also written that she was non-compliant.

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Sometimes You’ve Got to Get in Their Face

Refusing to take medicine

Woman, 86 years of age, very active, history of type 2 diabetes, but does not check glucose or even admit she has diabetes. She has refused to take any medications at all for the last 20+ years I’ve known her. Had gastroenteritis for 3 days. Even when well, she does not drink anything but coffee, and sometimes sugar-sweetened beverages, but only a few ounces of that at a time.

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Sugar Free, Gluten Free, And Vegan Are NOT Carb Free

Closeup on young housewife with vegetables in kitchen

Woman, 53 years of age. Type 2 diabetes and is obese. Patient’s daughter was getting married. She was very motivated to lose weight for the wedding and she did. Her A1C lowered from 7.5% to 6.6%. She cut back on her carbs to <100gm/day, increased her activity and took her metformin regularly. She lost 22 pounds over 6 months. The wedding was 2 months ago and she has gained 6 pounds. That may not seem like much, but it was enough to raise her A1C and open her eyes.

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