Give a diabetic sugar before insulin? | Figure 1

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Give a diabetic sugar before insulin?

I was at work this evening and had a patient with DM controlled with insulin. Daily they take Lantus 16 units in the morning and then Apidra 7u with meals. This evening their BG was 81 and they refused their apidra, also, prior to being seen by the endocrinologist there were parameters in the apidra - hold of BG less than 90. So that being said I faxed the endocrinologist and asked them if they would like to reinstate the parameters of the apidra, and also made them aware she refused her dinner dose. His response was that she should still get it (yes, but she refused) and then he stated that if her BG is less than 80 to give her 15g of sugar and then give her her apidra dose. Is this common practice to bump up a diabetic just to give them insulin? And if so, why? Her BG at HS was 188 even without the dinner apidra. Just curious why she should be given sugar just to get insulin. Thoughts?

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