Misadventures in insulin therapy: are your members at risk?

The goal of this supplement is to increase awareness of and insight into the importance of preventing medication misadventures and provide new perspectives on effective management of diabetes through improved insulin therapy and review the issues that represent barriers to achieving treatment goals. Opportunities for managed care pharmacists and health care practitioners to influence enhanced quality of life, decrease mortality, and reduce health care costs will be highlighted. Attention will also be given to error prevention strategies, including improved preparation, storage, delivery, and administration of insulin products.

The prevalence of diabetes mellitus continues to increase at an alarming rate, spurring a corresponding increase in the use of insulin. Insulin therapy, although currently the most effective treatment for patients with type 1 diabetes and many patients with type 2 diabetes, is fraught with safety concerns, especially those associated with medication errors. As glycemic goals have become more rigorous (ie., glycosylated hemoglobin levels of <6.5%-7%), clinical studies have clearly shown that intensive insulin therapy (3 or more injections daily) is often a necessary step toward achieving satisfactory glycemic control. This supplement explores the current level of diabetic care; the barriers to optimal insulin therapy, including medication errors; and the myriad factors that can increase the risks for medication errors among physicians, managed care pharmacists, and patients. Strategies for reducing medication errors in the management of diabetes are also considered.