Diabetes Self-Management Articles

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How to Avoid Errors in Diabetes Care

by Patrick J. O'Connor, MD, MPH, JoAnn M. Sperl-Hillen, MD, and Becky Klein, RN CDE

Medical errors generally make the news only when they are particularly dramatic — the wrong leg is amputated, for example — or tragic — someone dies. But less sensational errors take place every day in numerous settings. Some errors happen in hospitals, some in doctors’ offices, some in pharmacies, and some in people’s homes, when, for example, two drugs are mixed up or a dose is forgotten.

With all of the steps involved in diabetes care, it is perhaps no surprise that about 80% of people with diabetes experience at least one error in their diabetes care over the course of any one year. Knowing about some of the most common sorts of errors in diabetes care can help you learn to avoid them.

Avoiding incomplete care
Controlling blood glucose levels is often the primary focus of diabetes care, but it should not be the only focus. That’s because people with diabetes have a high risk of dying from a heart attack or stroke, so reducing that risk — by controlling blood pressure, controlling blood cholesterol, using aspirin when appropriate, and avoiding tobacco — is important, too. Failing to address a person’s risk of heart attack and stroke could be called a medical error.

To get a very good idea of whether you are doing all you can do to prevent a heart attack or stroke, ask your doctor the following questions at your next visit:

  • Is my A1C less than 7%? (Your glycosylated hemoglobin level, also called your HbA1c or A1C level, is a measure of blood glucose control over the previous 2–3 months. The lower it is, the lower your chances of developing diabetes complications.)
  • Is my blood pressure less than 130/80 mm Hg?
  • Is my LDL cholesterol (”bad” cholesterol) less than 100 mg/dl? (For people with heart disease, the recommended goal is less than 70 mg/dl.)
  • Should I be taking an aspirin each day to prevent heart problems?
  • Can you help me stop smoking?

If you are able to achieve the recommended goals for blood glucose, blood pressure, blood cholesterol, and smoking cessation and to maintain those goals over a period of five or more years, you can slice your risk of heart attack or stroke by more than half and very likely add several extra “good” years to your life. If you are not currently meeting these goals, ask your doctor what else can be done to lower your risk of heart attack and stroke.

Avoiding medication errors Many medicines can be used to help control blood glucose levels, but not all are appropriate or safe for everyone with diabetes. In fact, it is estimated that about 10% of people with diabetes are on a medicine that may not be the safest choice for them. The table “Avoiding Medication Mistakes” gives some safety guidelines for choosing which drugs to take. Because so many treatment options are now available, and because so many drugs and other substances can interact with one another, it is important that you and your doctor pick out the medicines that are best for you.

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Avoiding Medication Mistakes



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