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Discharge Planning For Diabetics Should Begin at Admission


 

EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE SOCIETY OF HOSPITAL MEDICINE

"Most of us really don’t have a clue about the real costs of medications, supplies, strips, lancets, lab tests, and medical office copays," he continued. "The average price of a blood glucose strip is $1.25. If you’re telling them to test four times a day, that’s $140 a month and almost $1,700 a year, if they test the way they should."

Going generic with medications can help patients save money and boost the chance of successful management. "This [name brand] stuff is not cheap. Patients can get a month of generic metformin and sulfonylurea options at a discount pharmacy for $4, or 3 months for $10."

Analog insulins are considerably more expensive than "good old NPH [isophane insulin] and regular insulin," Dr. MacIndoe said. "Given that fact, I would strongly suggest that you consider sending the patient with financial barriers home on NPH and regular because of its affordability. This combination will work if the patient remembers to eat regularly, particularly at lunch and snack time."

Finally, he said, get these patients back for a follow-up within 2 weeks of discharge. "It’s critical that they be seen 7-14 days afterward, particularly if they’re on a new regimen. It’s usually easier to get them to the diabetes educator, since most physicians are too busy, or too focused on the main reason they were in the hospital rather than [on] their diabetes."

Dr. MacIndoe disclosed that he is on the speakers bureau of Sanofi-Aventis.

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