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When is good enough, good enough?

Jun 6, 2010

When is good enough, good enough?

This past month I have been working on a CE/CME for pharmacists and physicians. The focus has been on diabetes control in the long term care and assisted living facilities. I started on this path because of a conversation with a former colleague who is now with a large LTC corporation.

We were discussing the value of basal/bolus dosing over sliding scale dosing in the LTC setting and how to convert to that system.

During our discussion it became apparent that most LTC patients are on a “just get by” diabetes management plan, and could certainly benefit from tighter control. She mentioned that in her facilities the main focus was preventing hypoglycemia, and often that was more important than good control. In addition she did not have faith in her nursing staff to calculate dosing accurately even with equivalency charts, and she was concerned that if they used the rapid acting insulin at meals by the time the food was delivered patients might be low. We quickly realized that all of the residents were lumped into one group that “could not do a thing,” but we found that many of her patients could do the testing and injections themselves and quite a few had counted carbs before they were at the facilities. This probably applies to our community patients as well. Too often we assume that because they are older that we only need to be good enough when they want to be better than good.

Sheri Colberg, Ph.D., has been answering your questions for the past few weeks, and she will get back to that soon but she thought that with the warm weather it might be a good time to give you and your patients A Little Nudge to Exercise.


4th Annual Diabetes Forum, presented by TCOYD and Close Concerns: Monday, June 28, Orlando, Florida
A Benefit For: Taking Control of Your Diabetes. Close Concerns invites you to attend the 4th annual diabetes forum to benefit Taking Control of Your Diabetes, 501(c)3. On Monday, June 28th, at at The Peabody Hotel in Orlando, Florida, an esteemed panel of diabetes experts will present a fast-paced panel discussion. For more 2010 upcoming conference details, please go to TCOYD.org.


dLife.com: June 6, 7PM ET on CNBC
Topics: From mobile apps to mini meters, what’s new in the world of diabetes gadgets and gizmos. Also, dLife visits a basketball superstar who has dedicated his post-season career to making life better for kids with diabetes, and Jim Turner gets physical with a man who excels in not one, but three sports. Special Guest: dLife CEO Howard Steinberg. Sundays on CNBC at 7 PM ET, 6 PM CT, and 4 PM PT. Catch up on dLife.com.

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Dave Joffe, Editor-in-chief