Disasters Averted

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 …

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 …

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 …

This is a repeat Disaster Averted originally published in 2013, but it is still valid. Just think about if it had been one of the newer insulins. Doubtful it would have been that easy to replace. No, it would not have been as easy. See next week’s How to Avoid Insulin Travel Disasters -- and do take heed and learn from today’s.

Recently I saw a type 1 DM patient diagnosed in 1980 at 15 years of age. She had not seen an educator in quite some time but had changed from NPH/Regular to Lantus & Regular….

I saw an obese long-term person with Type 2 diabetes who was experiencing widely fluctuating BGs and had had two hospitalizations within the previous six months, one for a BG of 28mg dl and one for an infested hair follicle (BG 413 mg/dl in ER)….

I was working with a patient who’d recently had a pump upgrade and although he said he didn’t have problems or issues with infusion set changes, I urged him to change his set while I was present. In the process, he did very well with filling his reservoir and inserting his …