Disasters Averted

The patient is a 91-year-old female with a 10-year history of type 2 diabetes. Two years ago, despite use of multiple oral hypoglycemic agents, her glycated hemoglobin (HbA1c) remained at 9.2% (77 mmol/mol) and her home glucose levels were in the mid-200 mg/dL (approximately 11.1 mmol/L) range. Her caretaker was …

I was reviewing a client’s insulin administration. She was administering Levemir (insulin detemir), 60 units, with a FlexPen. She said that she just dialed the dose to the maximum it would allow her as she knew it only would dial to 60 units. She did not confirm the dose visually. Although …

From our partners at the Institute for Safe Medication Practices (ISMP.org): A nurse gave orange juice to a patient with a blood glucose level of less than 50 mg/dL, but it did not raise the glucose level much, so he administered a dose of IV GLUCAGON EMERGENCY (glucagon) per policy. …

When prescribing NovoLog® Mix 70/30 analog insulin, health care professionals may write an unclear prescription, or if using an EMR system, inadvertently select Novolin® 70/30 human insulin instead. Be on the lookout for these errors. Read on for a breakdown of the key differences between these 2 types of insulin. Before …

I recently had a home care patient who had been discharged from a skilled nursing facility with a prescription for regular insulin, and who was put on a sliding scale dosage. The patient was experiencing hypoglycemic reactions. I was called to see him to find out why he was having multiple …

Recently I assessed an 84 year old inpatient with diabetes for his insulin usage at home. In reporting his dosing he stated that after he checked his glucose before each meal he took the "first two numbers of the result," and made that his dosage for meal-time insulin. For example, if the …

I recently saw a patient for a diabetes follow-up and had just gotten her lab values faxed over. Her A1c came back at 9.6 despite the patient telling me that her glucose meter readings were much lower. She even showed me the meter and upon doing some averaging, it appeared …

One of my long term patients called my office because she could not figure out what was happening with her post breakfast glucose readings. She counted carbs and would typically have a 2 hour ppg of no more than 145 mg/dl but even though her pre-breakfast readings were around 110 …

When reviewing the medical record of a hospital patient prior to meeting with her for a diabetes consult, I noted that the doctor had ordered 46 units of Lantus to be given daily at bedtime. When I went in to visit with the patient, she had a very strong accent …

Steve Freed, Publisher, Diabetes In Control Errors in diabetes care are a common cause of complications and can result in disability and even death. The diabetes errors being reported are probably much lower than the number actually occurring. The problem of errors in diabetes care facing health care providers is now …