Staff at a Maryland hospital discovered a patient safety issue with insulin pens that was traced to the electronic medical record’s (EMR) inability to generate patient-specific labels efficiently. A root cause analysis revealed the process gaps, and staff developed a solution that ensures patients receive insulin doses only from their own pens.
Emergency medicine providers commonly will encounter children with type 1 and type 2 diabetes. Unfortunately, the incidence of both is increasing, and the acute care provider must be able to recognize the subtle and dramatic presentations of both diseases. Early recognition and management of both the disease and its complications — diabetic ketoacidosis, hyperglycemic hyperosmolar state, and cerebral edema — are critical to ensure an optimal outcome.
The choices for insulin therapy are ever increasing with the development of new products that provide greater flexibility, greater range of effectiveness, lower risk of hypoglycemia, and lower pharmacokinetic and pharmacodynamic variability. These allow for individualization of treatment to match a patient’s daily life but typically at greater cost. This article will review the psychological, social, and clinical factors pertaining to the various insulin products, as well as strategies to initiate and intensify insulin therapy, to help clinicians supplement and enhance their clinical practices in diabetes management.
Despite billions of dollars in research and nearly 200 medications tested for dementia, pharmacologic treatment for Alzheimer’s disease is severely limited in effectiveness and safety. With the disappointing benefits of drug treatment, the promise of lifestyle changes to prevent and delay cognitive decline appears hopeful.
In this prospective, double-blind, randomized trial, the probiotic strain Lactobacillus reuteri SD5865 at a dosage of 1010 colony-forming units or placebo was provided to non-diabetic individuals twice daily for a period of four weeks to investigate the effect on various parameters associated with blood sugar handling, including secretion of insulin, C-peptide, and glucagon-like peptides-1 and -2.