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Discussion

diabetics

I need some advice from some of you experienced nurses out there on diabetes. We sometimes have diabetic patients who get covered and then when their meal comes don't feel like eating, vomit after a few bites, ask for seconds, don't want their bed time snack, want more of a bed time snack etc. I haven't had any clear cut answers on how to handle these situations and would like some input. What else can be offered for a snack other than the usual graham crackers and milk when somebody doesn't want this? Also, for someone receiving Lantus, do you need to do a BGT before giving this?? Any other advice on this from the trenches would be appreciated.

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I work evening shift. So if I gave them schedule and rainbow insulin and then they didn't eat, I would just be more alert to the possibility that there blood sugar might drop. The rainbow is to cover the increase level of glucose already in their system on the ac meal fingerstick, the scheduled longer acting would be a bigger concern. I would check an hs fingerstick even if not ordered and recommend night check at 2a. I would also remind the patient to report any symptoms they feel since they didn't eat.

Some of our endocrinologist routinely do 2a fingersticks, especially if they are changing patients dosage.

I would also always check a fingerstick before Lantus. What if the fingerstick was 77? I would call the doctor and see if he still wanted the same dose of Lantus given. Sometimes they will want it given since Lantus is a 24hour insulin.

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