It’s no secret that most of my clinical and research activities involve in bone and mineral metabolism, both in the lab and the clinic. In my new position I am faced with most of my patients coming to clinic for management of diabetes.
In my role as a clinician, I view myself as a teacher to my patients with diabetes, but for the most part, it is an uphill battle. More than 30% of my new patients with type 2 diabetes turn up at the clinic without a glucose meter and/or a blood glucose diary. If they do bring a meter, it is immediately obvious that they do not look at serial blood glucose data and do not know that they should have been taught how to adjust their insulin dosing, or preferably their eating habits, to maintain a more stable capillary blood glucose. When they are concerned about a high fasting glucose (ie, >300mg) they tend to overdose with insulin. Most often they elect to inject glargine twice a day.