May 20, 2014

Insulin Medications Very Prone to Error

As much as I advocate for insulin use,this study from the Pennsylvania Patient Safety Authority (PPSA) does explain some problems many diabetes patients encounter. The Institute For Safe Medication Practices states that insulin accounts for more than 10% of all drug mistakes. Even scarier is this drug class has been rated as having the most mistakes every year for the last 20 years.

The PPSA did their study of state hospitals focusing on medication errors. Dispensing insulin was the most frequent of all medication mistakes made.

  1. 20 percent of patients were given the wrong kind of insulin from the pharmacy.
  2. 18.4 percent of patients were supplied with the wrong mix of insulins.
  3. 17.4 percent of mistakes were due to misreading of prescriptions.

Obviously one of the reasons for the error rate seems to be due to simple confusion – with 13 different types of insulin available in five different categories and four similar names. The five categories are:

  • Premixed
  • Long-Lasting
  • Intermediate Acting
  • Short Acting
  • Rapid Acting

The similar names are:

  • Humalog
  • Humulin
  • Novolog
  • Novolin

See the chart here for the types of insulin. Now consider that in the next few years we can expect to see at least 3 to 6 more unique insulins that could be slower in action, more rapid onset, longer acting, and many more combinations. The number of mistakes can be expected to increase when the medication is insulin.

Many of the insulin medication errors can be very dangerous and cause death. This can lead to legal action and higher insurance rates. If you are hospitalized and you are able, always be prepared to check and recheck that you are getting the same insulin you use and check the carb count to be sure that you are not overdosed in the process.

I have had problems and the hospital wanted to give me Levemir only, but I use Lantus and Novolog. Since I had my own insulin and they did not have either, I politely refused and used my own. The second time I had just had an operation and was only allowed broth so I did not need insulin and politely declined other foods and knew I would be home before I would have reading near 140 mg/dl. The nurses did test my blood glucose and were surprised I knew what my readings would be (always within 5 points) and upon arriving home, my reading was only 132 mg/dl.

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