Insulin Therapy Center

Diabetes in Control recently asked our readers to help us examine the future of insulin delivery. See for yourself how your fellow members of the diabetes community plan on using insulin pumps and/or smart pens, now and in the future.

Younger patients with type 1 diabetes may require extra monitoring to avoid adverse glycemic events

Concentrated insulins are no longer just for patients who have obesity or insulin resistance.

Does giving children with type 1 diabetes insulin before each meal help them lower their HbA1c?

I visited a housebound patient who had uncontrolled blood glucose, in spite of her physician having increased her insulin dose over a period of two weeks to twice her previous dose.  The physician requested that I ask in depth about any factors that might be causing her to need so much more insulin.

I recently started working with a 58 y/o gentleman who had insulin dependent type 2 diabetes. He was 110 pounds overweight, and was using 120 units of Lantus and 30 units of Humalog daily. His most recent A1c was 8.6. The program he was placed on involved drinking a medical liquid food supplement 5 times a day which contains 12 grams of carbs per serving plus a meal that consisted of a small amount of protein and vegetables.

A VA Pharmacist received an order for 40 units of U-500 insulin and questioned its validity. The actual dose desired by the physician was 200 units. The physician indicated the 40 units reflected the mark on a U 100 syringe to which the patient was to draw back the plunger.  This was found to be a common practice so the VA developed a system requirement which required physicians to indicate the total units/mls (Example: 200 units/.4ml) for U 500. Insulin must be in the chart and syringes calibrated in mls must be used.

Can young children benefit from a hybrid closed-loop insulin delivery system?

I had the pleasure of working with an elderly gentleman who was living alone. When he switched from insulin pens to a vial and syringe due to his insurance, his numbers started to increase into the 400’s and 500’s. He was feeling weak and lethargic but fortunately was able to pull …

A physician asked me to see his patient, a middle-aged woman who was using an insulin pen.  She had extensive bruising at her injection sites, with no simple explanation.  She was not taking any medications associated with increased bleeding, and did not bruise easily otherwise. The physician wondered if there was something else about her injection technique that produced the bruising.