Sunday, December 9, 2012

Here's some insulin and have a nice day.

I have a friend whose spouse has Type 2 Diabetes.   Just recently Spouse experienced very elevated blood sugars and her primary physician prescribed NovoLog Mix 70/30.  She was told to inject insulin before breakfast and supper and to check her blood sugar 4 times a day.  She is to call in her logs and the doc would make the appropriate adjustments.  That's it.

Well, I'm sure that wasn't all of it but there was no emergency training for my friend, no more detailed training how to treat hypoglycemia and no Glucagon prescribed for Spouse.  No set number of carbs to eat.

I'm not familiar with Novolog 70/30 but I looked up that the 70% is intermediate insulin and the 30% is Novolog.  I don't understand how there is set amount of Novolog (fast acting) involved here but no set amount of carbs.  And just for breakfast and supper.  No lunch coverage?  Does the intermediate peak cover lunch?  How can she tell if there are no checks at lunch?  So on a carb heavy day she has to live with high blood sugar or for a no carb breakfast she risks going low? 

And let me tell you, I'm shocked (and disgusted) about insulin being prescribed with no emergency education or guidance treating a low.  (I believe they were told to use glucose tablets when first starting oral meds but nothing additional, as far as I know, when starting insulin.)  Shouldn't something like Glucagon go hand in hand with using insulin?  Or at least how to use a gel or rub honey on gums or...anything?  Are my expectation too high?  I don't think so.

We have only ever counted carbs so maybe I just don't understand the other ways. --No.-- I don't accept that.  An insulin, partially containing a fast acting insulin, was prescribed to a patient without any explanation of its duration or peak or how to match carbs to the insulin.  Was there any training on how to deal with insulin and sick days?  No emergency guidance.  Were they told to always carry a fast acting glucose with them?  Cripes, now I'm doubting everything.

I know not all patients are the same and some would want little information and just follow doctor's orders (or not) but I don't think this applies here.  I feel they are being ripped off.  Shouldn't complete education be the default?  Wouldn't this offer the patient a chance for the best health they could achieve?  Wouldn't this save everyone money in the long run?'s INSULIN for crying out loud.


  1. It's as if they assume the Dperson will always eat the same thing, and it will be carby to a level they are imagining in specific detail, but are unwilling to describe with numbers and words.

    They are lucky to have you thinking about this for them.

    1. It's hard not to run on and on and on. I have a lot to learn about other ways to manage D and I've realized I have a lot of pent up d-talk that needs out.