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Timing Matters, But Patient Reasons May Be a Factor

Sep 4, 2018

This is about one patient but the situation is not unusual for many patients who have type 2 diabetes and take insulin. Woman, 67 years of age, type 2 diabetes, taking Tresiba 15u every day at 11am and Victoza every morning upon arising, about 8am. She wears a CGM. Glucose levels were in target range for some time. Family reported patient was having some subtle cognitive changes. We did send her for neurologic evaluation.

I did start watching that more often. I noted patient’s glucose levels rising. I called the patient and asked if she has been missing her Tresiba, Victoza or both. She reported missing her Tresiba on many days. I asked her to think about why. She reported getting busy and forgetting to take it.


The day she was started on Tresiba, she picked up her first prescription about 11am and has taken it at that time ever since.

We discussed changing it to a time she would remember to take it. I recommended that since she always gets her early morning meds, to take it at the same time. She started doing that. She is doing that and now her glucose levels are back in her target range.

Lessons Learned:

  • Patients can get in habits and not realize these habits can be changed to make life easier and get their meds. Discuss the timing of patient’s meds and help make a more convenient way (time) to take medications.
  • Discuss reasons why people take meds at certain times. Some meds do need to be taken at particular times, but for some it doesn’t matter.
  • Understand that patients can fall into habits not realizing that simply changing these habits, such as timing of meds, can make a big difference.

Joy Pape FNP-CDE
Medical Editor, DiabetesInControl

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