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To the Editor.—
Although most diabetics who require insulin can be taught the mechanics of self-administration, older patients may present a special problem. They frequently have reduced visual acuity, making it difficult for them to see the markings on the syringes. Many will not admit that this problem exists; they often do not wear their glasses and make rough "guesstimates" of how much they withdraw into the syringe. Varying degrees of senility may be present, and, although capable of the mechanics of administration, they are sometimes difficult to convince that they must not take more than instructed. They may take "just a little more" because of increased food intake or just to "finish up the bottle." This can result in varying degrees of hypoglycemia with its attendant dangers. The physician, who is reasonably certain that he has correctly determined the proper insulin dosage, is puzzled and vexed.Problems with one
Fischer MG. Preloaded Insulin Syringes for Unreliable Diabetics. JAMA. 1980;244(6):548. doi:10.1001/jama.1980.03310060012007
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