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Question of Week | To Prevent Hypo’s, JR Stopped Taking Bolus Insulin

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JR is 26 years old with type 1 diabetes for over a decade.  JR keeps missing appointments and when you finally get a hold of them on the phone, they start crying and say “I am afraid my blood sugars will go too low, so I stopped using my bolus insulin”. They explain that they were too embarrassed to come in and have their data downloaded. Based on this information, what would be the most helpful approach?

  1. Provide reassurance and recognize that JR is dealing with childhood trauma.
  2. Encourage JR to start using half their usual dose of bolus insulin to get started.
  3. Recognize JR’s effort to prevent low blood sugars and explore their feelings.
  4. Remind JR that all of the downloaded data and reports are confidential.

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