Disasters Averted

From the Institute for Safe Medication Practices (ISMP: Recently there have been reports of a mix up of mixed insulins.   The insulins involved were: NovoLog® Mix (analog) 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart injection, [rDNA origin]) Novolin® 70/30 human insulin. Be prepared to address these potential …

From The Institute For Safe Medication Practices: Insulin accounts for more than 10% of all drug mistakes. This drug class has been rated as having the most mistakes every year for the last 20 years. When the Pennsylvania Patient Safety Authority did a study of state hospitals focusing on medication errors, they …

This week we have a review adapted from information provided by Novo Nordisk of the most common insulin errors which include: Clinician errors Self-administration errors Self-monitoring errors Improper insertion techniques Bad drawing-up procedure Insulin timing Using the wrong insulin Miscalculating insulin sensitivity factor Using an incorrect carbohydrate ratio Not checking …

From the Institute for Safe Medication Practices (ISMP): Insulin errors are number #1 on the list of drugs with the most errors. A major cause for that is the use of U500 insulin. Because of that, Eli Lilly is developing a new way to inject U500 insulin to help prevent …

From the Institute for Safe Medication Practices: Once again, a US hospital must contend with the fact that thousands of the hospital’s patients may have received an insulin injection from an insulin pen previously used for another patient. In this recent event, patients are being notified of possible transmission of blood-borne …

From our partners at the Institute for Safe Medication Practices (ISMP): Office staff at an endocrinology practice was asked to see a patient who was having low blood glucose while receiving their insulin using a Medtronic MiniMed Revel portable infusion pump. The pump allows information to be downloaded and it showed …

You may be surprised to learn that nurses sometimes inappropriately hold basal insulin doses (daily or every 12 hours) when a patient’s blood glucose is normal at the time a dose is due. This may be appropriate for mealtime or short-acting insulin products, but not basal insulins that can last …

Last week I saw a patient who seemed to be losing control of her blood glucose levels. She had been doing well and her A1c had been around 6.0 – 6.3 for the past couple of years. She was doing this while only on metformin 1000 twice a day. She …

I had a new patient who has had diabetes for decades. She was referred to me after her blood sugars went from good to bad. I asked her to bring her supplies with her when she came in to the office for her appointment. She did so and during her …

A patient came to my office to learn to use long-acting insulin. The referring provider’s note stated that the new patient, who was establishing care without outside records, was taking only mealtime insulin: NovoLog. During my assessment, the patient stated "NovoLog 75/25" was used three times per day, before meals. Knowing …