Disasters Averted

Recently I had a patient who was referred to me due to increased glucose levels, which happens all the time. However, this patient was referred because of the recent changes in fasting glucose levels. After attending a group diabetes class, the patient seemed to be improving self care and average fasting glucoses had dropped from around 165 mg/dl to 130 mg/dl. The readings held like this for two months and then started to rise again....

I asked a patient with erratic glucose levels where he usually gave his insulin injections to which he responded, "In my arms." I asked, "Could you show me where?" The patient promptly rolled up his sleeves and pointed to the vein in his antecubital space.

A female patient, 68 years of age, newly diagnosed with type 2 diabetes, had her initial visit with her endocrinologist and diabetes educator. Her second visit was then scheduled for two weeks later. However, the patient was a no-show for her second appointment....

A woman in her 60s, extremely insulin-sensitive with type 1 diabetes, came for a review of carb counting and blood sugar logs.  Pt had been running blood sugars above the target range. When asking pt why she thought her blood sugars were running high, she stated she was fearful of having low blood sugars....

 Over the years, I have had many patients come into the pharmacy requesting a replacement bottle of insulin because they’ve accidentally dropped a bottle. Recently, a patient shared one such experience....

We were asked to consult on a case involving BK, a 74-year-old man with type 2 diabetes (T2D) of 12 years duration. He was a retired restaurant manager who lived with his wife of 52 years. BK had a positive history of tobacco smoking (2 packs per day for 35 years), but he quit ten years ago following his grandson's birth. He monitors his blood glucose level two to three times daily....

I was working with a patient who'd recently had a pump upgrade, and although he said he didn't have problems or issues with infusion set changes, I urged him to change his set while I was present.  In the process, he did very well with filling his reservoir and inserting his infusion set. The problem was noted when he went to the cannula fill amount....

Recently a patient presented to our outpatient diabetes education center. His A1C had historically been elevated, despite the initiation of insulin therapy and increasing doses. The patient reported that he had taken all insulin doses as ordered, but was frustrated with his lack of progress....

A man 79 years of age was referred to me to start insulin. As a diabetes educator, I don't always have a full history and comprehensive labs given to me from the PCP. I met the patient and his family who told me his history, medications, lifestyle, etc....

I am a primary care provider in a small private office. A long-term patient of mine, 32 years of age, was recently diagnosed with type 1 diabetes. His insurance is now one I do not participate in. Until his recent diagnosis, he visited annually and paid out of pocket. He wanted to stay with me for his care....