Disasters Averted

A patient came to us on reasonably high doses of basal bolus insulin, using Levemir and NovoLog flex pens. He stated that he had been using insulin for a few months and was referred for more management assistance from his provider. He was seen by a CDE to review his …

About one and a half years ago I was evaluating the educational needs of a mid-30’s, female, hospital in-patient with diabetes mellitus type 2 (DM2). She and her husband both had DM2. Both were slender, active, did carb counting and followed all the prescribed recommendations of living successfully with diabetes. …

Can we “prevent” diabetes with weight loss? Or would it be better to say we can “delay” diabetes with healthy behavior? Often people are reluctant to admit that they have diabetes or to initiate treatment. Many times the cause of the delay in treatment is feelings of guilt (they feel …

A patient presented for outpatient diabetes education stating, “I really don’t know why I am here. I know I need to lose weight. I don’t know what else you can tell me.” She was reassured when I told her that there are people who are a perfect weight, exercise regularly, …

John, a gentleman in his 70’s who has diabetes, always visited my group after he exercised. I noticed he always had something (hard candy) in his mouth and he seemed tired. I asked him why he was doing this candy thing. He said, “After exercise I like to refresh my …

We were running a clinical study on erectile dysfunction. An obese 68-year-old male came in looking for help for his ED, so he thought he might qualify for the study. He had not had a medical workup for some time and wasn’t aware of any underlying diseases. I recommended he …

Janelle, an RN, is 36 years old with type 1 diabetes. She has a busy life between family and work. She eats healthy, exercises regularly, and wears a pump but occasionally has severe hypoglycemia, especially during exercise and at night. When I met her, I recommended she wear a continuous …

A 55-year-old woman with type 2 diabetes who was being treated with glimiperide had had a difficult time finding a job. She was finally hired into a law firm as a legal secretary. She would be frequently called into meetings at the last minute, often late mornings and afternoons, right …

Susan received a phone call from her clinician’s office recommending that she start using a pen for her insulin. She had also been prescribed a GLP-1 receptor agonist and was to go to the pharmacy to pick them up. She went and signed up for the long ‘discourse’ patients receive …

Ricardo, a 35-year-old man newly diagnosed with type 1 diabetes, was hospitalized for diabetic ketoacidosis (DKA). Once he was stabilized, he wanted to go home. He refused to learn how to self-administer insulin. However, he was told he would not be discharged until he self-administered insulin, at least one time. I …