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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.

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Timing Matters, But Patient Reasons May Be a Factor

This is about one patient but the situation is not unusual for many patients who have type 2 diabetes and take insulin. Woman, 67 years of age, type 2 diabetes, taking Tresiba 15u every day at 11am and Victoza every morning upon arising, about 8am. She wears a CGM. Glucose levels were in target range for some time. Family reported patient was having some subtle cognitive changes. We did send her for neurologic evaluation.

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Diabetes and/or Obesity: Whose Fault Is It?

Many people who have diabetes, especially type 2 diabetes, tell me they have no one to talk with about their diabetes. Why, with all the education and tools we have, do people who have diabetes still feel this way? My patients who have excess weight or obesity tell me the same thing. We may not have as much clinical information on that as we do diabetes as of yet, but the patients tell me the same thing.

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What NOT to Do When Your Patient is a Colleague

Health care professionals who are endocrinologists, cardiologists or who work in these specialized fields know the complications of prediabetes or diabetes. Many of us have these patients. Sometimes it’s almost natural to talk with these patients differently than we’d talk with most of our patients who aren’t as well-educated. A woman, 59 years of age with prediabetes and strong history of cardiovascular disease complained of a slight chest pain not associated with exertion or shortness of breath, just an ongoing discomfort. Other than this, the patient — who is herself a health care provider —  is feeling fine.

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Summer Camp Rejuvenation: Hitting the Reset Button

This summer I had the opportunity as a student pharmacist to attend a camp for youth with type 1 diabetes (T1D) and assist as a member of the medical staff. We spent the first few days setting up, going over camp procedures and policies, and preparing for arrival of the campers. This was my first time helping at such an event, and my expectations of how deeply the camp experience would impact the lives of the campers (and myself included!) were greatly exceeded.

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Summer Travel: Don’t Forget the Feet!

Summer, a time for travel for so many. Over the next few weeks, we will look at ways to prevent disasters during or after travel. When it comes to travel plans, a lot of people who have diabetes are most concerned about their medications — getting, bringing enough with them and so many issues associated with that. I've found most aren't concerned about protecting their feet.

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The Real Story Continues

When we first met this patient, he did not think he was getting the right treatment. When he visited one week later... When I asked him, and told him I would not judge him, he admitted to drinking a tea his mother recommended to bring down his glucose. He then mentioned several other supplements. His glucose was not lower, but higher.

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What’s the Real Story?

Man, 55 years of age, type 2 diabetes, hypertension, was referred to see us. The patient reports coming to us because he does not think he is getting the right treatment. Reports having been put on insulin upon diagnosis 4 years ago--at which time he had lost 50 pounds, was very hungry, thirsty, and had urinary frequency. When visiting, he did not have his labs from diagnosis but did have labs from 3 months ago at which time A1C was 7, and C-Peptide was 2.2. He said his past endocrinologist changed him to oral meds after his glucose had come down to an average of 140.

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How Much Monitoring is Too Much?

What I love about going to conferences is the realization that what I’m doing in my practice is in line with what others I respect are doing. That is meaningful, and I always learn a new pearl. If that’s all I gain from these conferences, it’s okay, but it’s usually more than that. I have just returned from the 2018 ADA Conference, where there was so much about new technology, particularly continuous glucose monitoring.

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