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Think Out of the Box!

Jan 26, 2016

An extremely insulin sensitive type 1 diabetic woman in her 60s came for review of carb counting and blood sugar logs.  Pt had been running blood sugars above target range.  When asking pt why she thought her blood sugars were running high, she stated she was fearful of having low blood sugars.  When reviewing her correction factor of 1 unit of insulin for every 60, the idea occurred to me we could use an insulin pen that dispenses insulin in 0.5 unit doses.  Therefore we could change her correction factor from 1:60 to 0.5 for 30.

Pt was extremely excited to get her blood sugars in tighter control AND that I had not made the assumption she was “afraid of tighter control.” We are accustomed to using the refillable pens delivering units of insulin in a 0.5 unit dose for children. Thinking out of the box for their use with older, extremely insulin sensitive type 1’s regardless of age can be a blessing.

Lessons Learned:

  • Think out of the box.
  • Don’t pigeonhole your patient into an age group or any group.
  • Think of optimal care, target ranges, for the particular patient you are dealing with.
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