Disasters Averted

I had a type 2 patient on metformin whose blood sugars were elevated every day at lunchtime. All of his other readings including fasting, pre- and post- dinner, and bedtime, were fine. When he demonstrated his testing method over a Skype internet video call, everything he did seemed correct. After …

Recently I saw a type 1 diabetes mellitus patient who was diagnosed in 1980 at 15 years of age. She had not seen an educator in quite some time but had changed from NPH/Regular to Lantus & Regular. She was interested in learning more about the insulin pens that were …

At our podiatry clinic, we had a Native American patient who came in once a week for diabetic ulcer debridement and dressing changes. He would do his home care and then return for further debridement and a new topical if the current one wasn’t healing the ulcer. Because it was …

I do a lot of inpatient diabetes education. One of my patients was new to insulin and needed to go home on twice daily injections of 70/30. We educated her with all she needed to know to be successful at home. Two weeks after discharge the patient experienced a severe …

When sitagliptin (Januvia) first came out, I was called by our legal affairs department about a patient of another MD at the University of Penn whose house staff had ordered 1000 mg sitagliptin instead of 100mg. As the drug had just come out, the staff was not very familiar with …

One of my patients had a serious head injury from a fall which resulted in an unconscious period of time when on vacation. She spent five days in a hospital neuro unit during recovery. She had a list of all her medications, medical history (brief), and latest lab work including liver …

This problem seems to be the one that we see most often in our office. We had a patient who had been through our diabetes education classes and came to see me for a one to one visit. She came into my office complaining that her blood sugars were still …

Sometimes being a medical professional can have a major impact on the people around us outside of work. Recently, my neighbor’s 12 year old daughter had a “drastic change” in her health. I noticed that she had lost a lot of weight, started drinking juice by the gallons, had no …

Fewer Errors in Hospitals When Pharmacists Are Involved Researchers reported last week at the conference of American Society of Health-System Pharmacists that, when pharmacists lead the medication reconciliation effort, providers see more accurate, complete, and up-to-date patient information at the time of hospital admission and discharge.

Courtesy of our partners at ISMP: One of my patients was asked to write out his home medications which he then did, including “U100 Novolin R insulin before meals and bedtime.” The nurse entered this into the E-chart for home meds as: “100 units of Novolin R ac/hs.” Because this didn’t …