About one and a half years ago I was evaluating the educational needs of a mid-30’s, female, hospital in-patient with diabetes mellitus type 2 (DM2). She and her husband both had DM2. Both were slender, active, did carb counting and followed all the prescribed recommendations of living successfully with diabetes. …
Read More »Change Language to Combat Feelings of Failure
A patient presented for outpatient diabetes education stating, “I really don’t know why I am here. I know I need to lose weight. I don’t know what else you can tell me.” She was reassured when I told her that there are people who are a perfect weight, exercise regularly, …
Read More »CGM Best Fit for Active Type 1 Patients
Janelle, an RN, is 36 years old with type 1 diabetes. She has a busy life between family and work. She eats healthy, exercises regularly, and wears a pump but occasionally has severe hypoglycemia, especially during exercise and at night. When I met her, I recommended she wear a continuous …
Read More »Hypoglycemia Can Impact Job Performance
A 55-year-old woman with type 2 diabetes who was being treated with glimiperide had had a difficult time finding a job. She was finally hired into a law firm as a legal secretary. She would be frequently called into meetings at the last minute, often late mornings and afternoons, right …
Read More »Not All Insulin Pens are the Same
Recently, a patient of mine called about her post-meal glucose levels which were increasing.
Read More »Assessing Insulin Administration Technique
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 …
Read More »Remote Wireless Monitoring Can Help Patients Newly Diagnosed with T1
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 …
Read More »New FlexTouch Pens Not the Same as the Old
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 …
Read More »NovoLog Mix 70/30 Confusion
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 …
Read More »Dosing Error Due to Accent Misinterpretation
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 …
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