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Juan Has Had a Change in His<br />
Blood Glucose Levels<br />
Juan has had blood glucose levels within<br />
his goal range for the past several<br />
months on his basal/bolus insulin<br />
regimen of 10 units insulin glargine<br />
(Lantus ®) and pre-meal insulin doses<br />
of 6 units of insulin aspart (Novolog ®).<br />
He uses an ISF of 1 unit for every 50<br />
mg/dl and a target of 100 mg/dl.<br />
For the past 4 days his blood glucose<br />
values have increased to over 140 mg/dl<br />
consistently. He has not changed<br />
anything in his routine and is not sick.<br />
He always carries his insulin aspart with<br />
him in the car so it is available if he<br />
decides to stop and eat.<br />
Q – What Could Have Made Juan’s<br />
Blood Glucose Reading So High Over<br />
the Past Four Days?<br />
1. His car might have been too hot,<br />
causing his insulin not to work.<br />
2. Juan might have been under a great<br />
deal of stress.<br />
3. His blood glucose test strips might<br />
have expired.<br />
A – Any or all of the above choices could<br />
be correct. Choice 1 – <strong>Insulin</strong> must<br />
always be kept at least at room<br />
temperature. Juan would have to<br />
open a new bottle and watch his<br />
glucose levels closely. Choice 2 – If<br />
Juan is having unusual stress, he might<br />
need a small adjustment in his insulin<br />
while this is going on. Choice 3 –<br />
Expired blood glucose test strips could<br />
be giving him inaccurate readings.<br />
48
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