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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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Make Sure “Quick and Easy” Food Plans Meet Specific Patient Needs

19-year-old female, type 1, insulin pump, and counting carbs, wanted to use a particular food plan that touted no counting and no need to worry about numbers. She asked me what I thought of that and I informed her that for weight loss, this can work for some, but she has type 1 diabetes, and she will need to check her glucose and most likely count carbs, or at least make some adjustments in her boluses at each meal.

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How Long Does the Insulin Last? Do The Math!

In assessing an in-patient's diabetic educational needs, I was reviewing with him his in-home regimen for his insulin therapy. Per his report, he stated that he took Levemir 50 units twice a day. I asked if it was by needle, syringe and vial preparation, which it was. I instructed him re: the shelf life of Levemir of 42 days once opened. He stated, "I throw it out after a month, but there is always insulin in the vial.” He also said he has more than an adequate supply. He was receiving his insulin by mail-order, receiving as he should, but not using it in a timely fashion. In other words, he was stockpiling his insulin.

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The Danger of Assuming a Patient “Knows What to Do”

Female, 41 years of age, A1C 7%, Indian, family history of type 2 diabetes, at least one was insulin-requiring. For unknown reasons, perhaps the fact the patient was a personal trainer and “should have known what to do,” her hcp didn’t put much attention on her A1C, nor was she asked to return for follow up. For various reasons, one of which was not having insurance, she did not return to a hcp for 3 years.

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Lowering Carbs Can Be Helpful Tool in Weight Loss for People with Insulin-Requiring Diabetes

Female, 28 years of age, diagnosed with type 1 diabetes at age 25. She was taught to manage her diabetes with a basal/bolus insulin regimen and meal plan prescribed by health care team. She was taught she could eat anything she wanted as long as she covered her carbs with rapid-acting insulin. Her glucose was in control, but she gained 50 pounds over the first year. She then attributed her weight gain to taking insulin, so she would not take enough insulin to cover her glucose levels.

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Sometimes Long-term Patient/Healthcare Provider Relationship Must Be Severed

I am a primary care provider in a small private office. A long-term patient of mine, 32 years of age, was recently diagnosed with type 1 diabetes. His insurance is now one I do not participate in. Until his recent diagnosis, he visited annually and paid out of pocket. He wanted to stay with me for his care. I realized his needs were most likely more than he could afford.

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Know Your Pen Needles

In a follow-up visit for an insulin-requiring patient with type 2 DM, it was obvious that the management of his DM had deteriorated. According to his girlfriend, this patient ate only 1-2 meals a day, but they tended to be high-carbohydrate meals. We reviewed the patient's insulin regimem in detail and ascertained that he was using the sliding scale correctly.

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