Tuesday , November 21 2017
Home / Resources / Disasters Averted (page 2)

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.

Submit Your Story!

Helping Patients to Achieve Behavior Change

Man, 76 years of age, type 2 diabetes, obesity, SP right total hip replacement one year out. When preparing for hip surgery, was on basal and bolus insulin, metformin. Had been on a GLP-1 but had diarrhea so he stopped. Was able to, for the most part, follow a lower carbohydrate meal plan but was not active. When he first started coming to us for weight loss to prepare for his surgery, his weight was 304 pounds, BMI 45, A1c 9.9%, Cr 1.87, eGFR 34. We decreased his metformin from 2,000mg/day to 1,000mg day and referred to nephrology. With this change and being motivated for surgery, he lost weight and in 6 months went into surgery having lost 25 pounds with an A1c of 6.9%. Note, due to eating less carbs, he could take less insulin, which seemed to help his appetite. Surgery was performed and he did well.

Read More »

What’s the Best Teacher?

Over the years I’ve found the best teacher for people who have diabetes is their numbers. Without teaching the patient targets, they don’t learn much. This patient is just one example of many. A man, 57 years of age, visits a community diabetes education course. He tells me he has type 2 diabetes, hypertension hyperlipidemia. He said his doctor told him his numbers were fine about 9 months ago. When he came to the course, he was losing weight, was thirsty and was very tired.

Read More »

Monitoring Insulin Temperature

I have type 1 diabetes and have been living with it for the past 11 years. I take daily insulin injections to stay alive and well. A couple of years ago, I had a very frustrating incident when my insulin stopped working. I began injecting loads of insulin, and even with multiple doses my blood glucose wouldn’t drop.

Read More »

What is the Most Ineffective Medication?

As we know, the most ineffective medication is the one needed but never taken. There are many reasons our patients don’t take prescription medicines, but a biggy is the cost. If a medicine is too expensive, the patient will not fill the prescription, therefore won’t take it. For example, when ordering an SGLT-2 and/or GLP-1, each can cost hundreds or more for a month’s prescription. Some are covered for both. Some are covered for one brand, but not the other.

Read More »

Just Because It Says “—” Doesn’t Mean It Is

Male, 62 years of age, type 2 diabetes, class III obesity. Has been on metformin, 1,000mg twice daily. Glucose in the 200-300mg/dL range. A1C. Taught about lower carb meal plan, started on Trulicity, first 0.75mg, then 1.5mg/dL. Made the dietary changes right away with the addition of the Trulicity. Within 2 weeks glucose levels averaged 125, patient losing weight, decreased appetite and feeling good. More energy. Insurance did not cover Trulicity, but did cover Victoza, so started on Victoza. When made the change, started with the 0.6mg daily, then increased weekly to the 1.8mg/day.

Read More »

Beating Diabetes…My Way

Since Team Novo Nordisk’s inaugural season in 2013, 30-year-old Romain Gioux has dreamed of racing as part of the world’s first all-diabetes pro cycling team. Diagnosed with type 1 diabetes at age 15, he raced as an amateur for a French-based Club, but this year serves as his professional debut.

Read More »

Not All Insulins and Not All Syringes are U-100

Problems associated with the use of U-500 insulin syringes. We received two reports of accidental prescribing of the new BD U-500 insulin syringes for outpatients who were using a U-100 insulin product. In one case, an endocrinology clinic called the hospital pharmacy to ask how to order U-500 syringes. During the conversation, it became apparent that there was some confusion about the use of these syringes. The pharmacist stressed that the patient should not use a U-500 syringe to measure any insulin concentration other than U-500, or the measurement would be incorrect, leading to a 5-fold underdose.

Read More »

Concentrated Insulin Pens and the Visually Impaired

An endocrinologist prescribed a U-200 TRESIBA (insulin degludec) pen for an 88-year-old woman with labile type 1 diabetes and recurrent hypoglycemia. The patient also has severe macular degeneration with visual impairment. Visually impaired patients commonly use touch and sound to assist them.An endocrinologist prescribed a U-200 TRESIBA (insulin degludec) pen for an 88-year-old woman with labile type 1 diabetes and recurrent hypoglycemia. The patient also has severe macular degeneration with visual impairment. Visually impaired patients commonly use touch and sound to assist them.

Read More »