IV meds vs oral meds

By Oklahomahelper Latest Reply 2011-08-11 23:10:03 -0500
Started 2011-08-08 07:17:09 -0500

My 82 year old father was recently dismissed from the hospital after a 4 week stay (fractured patella/surgery/infection). Prior to his hospitalization his diabetis was very well maintained by Glipizide and Metformin (orally). When he came out of surgery they started him on insulin without our knowledge. It wasn't until 3 days later that we realized he was receiving Lantus and Novalog IM instread of the oral meds. Now, 4 weeks later they dismiss him with a "sliding scale chart" and the IM insulin. My father lives with my mother and is her care giver but neither of them is coherent enough to manage this horrid regimen of insulin. My sister and I have taked two weeks vacation to try to get him settled but each day is worse than the one before. He just can't understand it. I'm taking him to his primary doctor tomorrow (who, I might add, is NONE too happy about the insulin because he knows how easily confused my father is). Is there any hope we can get him off the IM insulin and back on the Glipizide and Metformin. He is currently taking 30 units Lantus a.m. and 5 base units Novalog before each meal, plus whatever units are necessary according to his levels. There will be NO ONE to administer his meds in two days.

3 replies

Graylin Bee
Graylin Bee 2011-08-11 23:10:03 -0500 Report

When I was in the hospital last year first with cellulitis and MRSA, then later for a surgery they gave me insulin. But also started me on Metformin. Once I was out of there it was only metformin with an order for insulin only if I hit 300. Since the infection and wounds have healed my BG has been better (along with using diet and exercise). Did his BG go up during the surgery and infection and healing time? That would be my guess as to why they had him on insulin. Maybe they felt it gave better control at the time. Hope your Dad's PCP can answer your concerns and help get him back on an easier to manage medicine.

GabbyPA 2011-08-09 09:19:32 -0500 Report

Is he having better control on insulin or was the oral better? That should be a considering factor. If insulin is working, is there a day nurse service that could help or are you all too far away to keep an eye on him when the nurse is not there?

jayabee52 2011-08-08 14:19:29 -0500 Report

Howdy OKhelper! WELCOME to DC!
As long as your dad was having good BG numbers with his oral meds regimen, I would see no reason that he couldn't return to that regimen. That your dad's PCP is not happy about the insulin is in your dad's favor to return to oral meds.

I was changed from Metformin to Insulin as a result of a hospital stay also. In my case my kidneys had an infection which shut them down and necessitated dialysis. I was a bit confused by the injections at first, but I adapted —- but I was only in my mid 50s at the time. Hospitals often change the diabetes care given simply because it is easier for THEM to administer insulin than oral meds. In my case, I think it was concern over what the Met. might be doing to my renal function.

I am wondering about one little thing. in the title you mentioned IV meds and later in the posting you mention Novolog IM. I know that insulin can be administered by IV, since my bride had a Blood Glucose reading so high that neither ours nor the hospital's meters could read it. They merely said "hi" (friendly meters! LoL!). They put Jem on IV insulin to bring her down, but they had to watch her closely to make sure she didn't crash too low. I understand that the IV treatment is only available in hospitals and maybe quick care facilities due to the need to check blood frequently for lows. Could I be mistaken?

And Novolog IM is a new term to me. For what does the IM stand? Is this something new?

Most insulins are administered in the home by subcutaneous injections, either via syringe or insulin pen.

Praying God's richest blessings on you and yours, helper!


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