It is tempting at times to give up when hitting a brick wall. Today, I celebrated breaking through the brick wall.
Meet Sally a senior adult with Type 2 diabetes that I have been working with and supporting her in managing her Type 2 diabetes. I have felt like I keep hitting that “brick wall” with Sally. Today would be different.
I reviewed Sally’s chart when I arrived at office this morning. At her last office visit, her blood sugar was over 500 mg/dL. Oh no, I thought. She had been closer to target range prior to that office visit. What was happening? When Sally arrived for her visit, I checked her blood sugar and reviewed her blood glucose log (most values in 300 – 499 mg/dL range). Oh no! I assessed her abdominal area for any fatty deposits (lipodystrophy). No fatty deposits. I asked her to demonstrate how she injected her insulin. Spot on, no issues with insulin administration. So I ask her about her 500 mg/dL blood sugar during last office visit. She states, “I ate a tomato sandwich without taking my bolus insulin.” Ummm. Now, I honestly did not see how that would cause such a glucose elevation. Keep digging! Keep digging! After doing a diet recall with her, the pieces of the puzzle still do not fit. Ummm…what about beverages? She only drinks orange juice when her glucose is low. Turns out, she loves to drink an old fashioned Coke Cola. She enjoys drinking her coke most every day. The culprit for the significant glucose elevation..an old fashioned coke. After a bit of discussing and bargaining, Sally agreed to limit her coke to only when she had a low glucose. Often times, we must dig, dig and dig to discover the obvious.
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