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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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Sugar Free, Gluten Free, And Vegan Are NOT Carb Free

Woman, 53 years of age. Type 2 diabetes and is obese. Patient’s daughter was getting married. She was very motivated to lose weight for the wedding and she did. Her A1C lowered from 7.5% to 6.6%. She cut back on her carbs to <100gm/day, increased her activity and took her metformin regularly. She lost 22 pounds over 6 months. The wedding was 2 months ago and she has gained 6 pounds. That may not seem like much, but it was enough to raise her A1C and open her eyes.

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Valentine’s Days, Holidays, Obligations, and Associations

Woman, 63 years of age, history of ovarian cancer, prediabetes, hyperlipidemia, has been trying to lose weight for years but was unable to do so. She is very family-, friend-, colleague-oriented. Every holiday she thought she had to make or bring and eat whatever special holiday food was associated with the holiday. She couldn’t let anyone down by not bringing, or by not eating what other people brought. We met weekly for the past three years. Every week there was some excuse about how or why she “cheated” or if there was a week she didn’t think she “cheated,” then she was afraid she would.

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Life Happens to Our Patients Too. Be Understanding.

Woman, type 1 diabetes, 63 years of age. Well-educated diabetes wise. Reached out to me saying: "HELP!! Normally I take 10 units of Toujeo at 9 pm. I did that last night. This morning I meant to take an additional 2 units because I'm not getting any exercise due to a knee injury. By mistake I took my usual dose of 10 units." Before I read the rest of her email, I thought, I know her. She knows what to do. She wears a CGM, she’ll be watching that. Then I read on...

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Teach Not to Hate Insulin

Man, 63 years of age, type 2 diabetes, obesity, hypertension and hyperlipidemia, referred to me, a CDE, to start him on and teach him how to use insulin. He has had diabetes education in the past, tried lower carb eating and physical activity, but glucose levels still elevated. He told me he felt like a failure. He said he learned he was insulin resistant, made too much insulin, which was causing his co-morbidities. He was very resistant to start insulin, especially since he thought insulin was the cause of his problem.

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A Different Kind of Disaster

When we think about disasters, we usually think of the outcome, a poor health outcome. We don’t always think about the journey. The journey to poor health outcomes are many. Today I am reminded of not having the insurance coverage for the correct medication. Without it, one can have a disaster, poor diabetes management. The consequences of that, as well as the disruption to running a smooth office.

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Watch Out. It’s That Time of Year Again.

Yes, it’s that time of year again when your phone/email/computer is busy with patients wanting appointments and making commitments to make their New Year’s Resolutions. Often at this time of the year, my patients come in wanting to change just about everything about what they eat, when they eat, how much they eat, and the same for being physically active. So many of these patients have told me they have tried and tried and tried and failed in the past, but now it’s the New Year and it’s going to be different.

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Winter Highs

Female, 20 years of age, type 2 diabetes, is obese with anxiety disorder, untoward response to several classes of agents. Reports eating lower carbs since last seen. During the warm weather, random glucose levels and A1C were near normal. Today is a cold winter day. Random glucose 188mg/dl.

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The 5 Rights of Medication Administration

Male, 56 years of age, type 2 dm, hypertension with orthostatic hypotension, peripheral neuropathy, hyperlipidemia, class II obesity. He fills his pill box every month and has been doing so for years. It has taken some time, but we finally came up with a plan with his meds and lifestyle where he has been feeling very well and his numbers are better than ever. He filled his med box a week before contacting me. He wasn’t feeling well. Feeling dizzy and his legs were feeling like rubber.

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