Disasters Averted

A woman, 72 years of age, type 2 diabetes, obesity, taking metformin, GLP1, ARB, and antidepressant (SSRI). Lost 20% total body weight in the past year. Recently complaining of dizziness and weakness. Glucose levels in the 60’s at home, at which time had symptoms of hypoglycemia. Glucose-lowering medications (metformin and GLP-1) were stopped. Continued to complain of dizziness and weakness especially in the morning.

Man, 52 years of age, type 2 diabetes, obesity class II on Victoza. He was very pleased with treatment response, lowering glucose levels, feeling full and more satisfied, but having a skin reaction.

When reviewing the medical record of a hospital patient before meeting with her for a diabetes consult, I noted that the doctor had ordered 46 units of Lantus to be given daily at bedtime....

Male, 72 years of age, type 2, insulin-requiring diabetes, also taking SGLT-2. Annual physical. No urinary complaints during the visit. Received annual lab work end of the workday, glucose elevated much higher than the reports. WBC elevated, 1200, no urine culture, but U/A did show cloudy....

Several warnings have been issued by the CDC regarding unsafe practices that might result in the transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and other infectious diseases during assisted blood glucose monitoring and insulin administration.

During a recent phone follow-up call to one of my patients, a co-worker and I avoided a "Diabetes Disaster." My patient told me that she had received her mail-order refill for "ASPART," but the bottle didn't look the same....

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....