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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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Misuse of New Insulin Strengths

We certainly have important education to accomplish with patients and health professionals regarding the new higher concentration insulin products that are available only in a pen, including U-300 TOUJEO (insulin glargine), U-200 TRESIBA (insulin degludec), and U-200 HUMALOG (insulin lispro). U-500 insulin is also available in a pen (HUMULIN), although vials remain on the market. Patients may not understand proper dosing and dose measurement with these higher concentrations of insulin products.

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Where There’s One Autoimmune Disorder, There May Be Another

Male, 32 years of age, type 1 diabetes, was following gluten free diet of his own choice. Was never diagnosed, just "feels better" when he doesn’t eat gluten. Has lab tests that were negative for celiac in the past. Came to see me for follow up diabetes education. Noted weight loss of 5 pounds in one week. Glucose levels were not elevated, in fact for the most part in target range.

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It IS What You Say

Working with a patient, a woman, 44 years of age, who has had type 1 diabetes 21 years. She had a day of high glucose levels. We worked together very hard all day correcting to bring it down. After being closer to her target range, not low by any means, she told me she just had some chocolate. I asked her why, after the day she had, did she choose chocolate.

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Make the Goal Personal to Motivate

Male, 66 years of age, type 2 diabetes, class III obesity, peripheral neuropathy, multiple toe amputations, hypertension, hyperlipidemia and, most importantly, a 2-year-old granddaughter. Patient taking 100 units long-acting insulin, sulfonylurea, metformin, beta blocker, and statin. Checks glucose once in a while; in the 200 to 270 range when checks. A1C 9.3%.

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One Bite at a Time

Woman, 42 years of age, class III obesity, type 2 diabetes diagnosed in the past year, binge eating disorder. Very motivated to change lifestyle when first diagnosed. She goes off and on her medication. When off, she binges. As an hcp, I wondered about the severe changes from totally "on" to totally "off." Yes, this patient is receiving counseling, CBT.

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