Disasters Averted

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 …

Recently, a patient of mine called about her post-meal glucose levels which were increasing.

An 83-year-old woman who lived alone and was very active in her community was having wide swings in her glucose levels. She reported sometimes waking up hours after dinner with her head in her dinner plate. She did not understand why. She did not have family or caretakers nearby to …

A patient of mine was newly diagnosed with type 1 diabetes. He started on insulin and I taught him about glucose targets; insulin administration, including the signs and symptoms of hypoglycemia; and how to prevent, recognize, and treat hypoglycemia. I also taught him about the “honeymoon period,” which, I told …

A patient of mine who had diabetes and peripheral neuropathy came home from the hospital after a below-the-knee amputation of her right leg. She lived alone and was housebound. Having lost one leg, I knew she was at increased risk for losing her other leg. While in rehab, she had …

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 …

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 …