Pharmacy not giving insulin as prescribed

My aunt has t1 and she is on lantus solostar and her pharmacy hasnt been giving her insulin they way its prescriped. she is prescribed 5 boxes a month and for the past 6 months has been recieving 2-3 boxes and has been put in the hospital 2 times because of it. and now tonight she used up her last pen which only had 20 units in it which she takes 70 in the am and 50 in the pm she did not take it this morning 1 hour after taking her lantus her level was 391 and her pharmacy is not open until tuesday and cant get to a hospital or pharmacy unless the pharmacy delivers because we dont have a working vehicle.she also has ms which has been acting up lately. im new to diabetes and ms and i dont know what to do for her, but she says its no big deal and that she can make but barely to tuesday and im not sure if i want her to risk it . she has 2 young kids that get upset when she leaves to go to the dr cause they think shes not gonna come home for awhile. i need help

I'm having trouble making sense of this, Kayla. A type 1 who takes 70 units of Lantus in the AM and 50 in the PM would be very unusual, though not impossible.Five boxes a month is 25 pens a month which would be an awful lot of Lantus. Does she also take fast acting insulin? Most people take both long acting (Lantus) and fast acting. She should be using her fast acting to correct if she's high.

For the future, if she is not receiving the amount of insulin her doctor prescribes, she should call her doctor's office and have them contact the pharmacy.

She should be correcting her blood sugar to get it down. As well as correcting, she should be drinking a lot of water. If she doesn't feel well, like vomiting she may be in danger of DKA which is a medical emergency and she should call 911.

she is not on a fast acting she just takes the lantus and she has talked to her doctor and he has called the pharmacy right in front of us and still nothing has changed we are waiting till its time for her to refill to switch to a different pharmacy but its not until october 18th when she can refill through her insurance because the pharmacy tells the insurance that she is getting all of her insulin. see im new to all this and im not quite sure which type she has i just assumed it was t1 but im not sure what the difference is between them. she doesnt feel like vomiting she just feels tired and in alot of pain because of her ms. how can i tell what kind she has, is there a way?

Yes, blood sugars that high do cause fatigue, and she needs to get her numbers down. Lantus will not bring her numbers down because it is long acting. She needs to see her doctor or go to an ER to get insulin and to get her blood sugar down. Is she newly diagnosed? Does she know what type she has? Is your aunt disabled mentally? She should be working closely with her doctor who is the one who would determine her type, and also have her on a more suitable regimen of MDI which would include both long acting and short acting. Her doctor should be intervening with the pharmacy, and if there is an issue he can provide her samples. An insulin dependent diabetic cannot just run out of insulin. There is something wrong with this picture.Pharmacies don't just refuse to fill doctor's orders. It sounds like you are trying to help but my guess is you don't have all the information. Is she not able to take care of her own diabetes?What kind of pharmacy is closed from Saturday till Tuesday?

i just started taking care of her because of her ms. she has diffuclty remembering stuff so she forgets she has diabetes and has to take insulin. i have only been taking care of her for about a month which is when i moved to her in texas from iowa. she is only seeing a pcp not a specialist. i was told by her father that she was born with it but im not sure. i wish i could ask her more about it but she doesnt remember alot of stuff

Are you saying her blood sugar is 391 and she is out of insulin? If so, she needs to go to the hospital. That is a medical emergency, as it will only go higher.

It sounds like a very difficult situation, Kayla, and though you really want to help your aunt, she may need more help than you can give her.I think your aunt is confused, and not the pharmacy refusing to give her insulin. I wouldn't even be sure she knows what kind of insulin to take and how much and that could be extremely dangerous. I would suggest that first of all you deal with this crisis now by getting her somewhere she can get insulin. After that I think you and whatever other family is available and others in her support network need to meet with her doctor to determine a plan that ensures she gets the care she needs. This likely will mean a social worker needs to become involved in her case and consider all the alternatives. You need help and support in order to help and support your aunt. You can't do it alone.

sorry just looked at some of hee medical paper work she is in fact type 2 and yes her sugar was 391 i just checked it and it is 113 now

Yes, she sounded more like Type 2, but that isn't really as important as the fact that she is dependent on insulin. it's good that her blood sugar came down. But if I'm understanding correctly and you are saying she is now completely out of insulin, it is going to go back up...way up. She needs to be seen as soon as possible. Do not mess around with this. If she needs insulin and has no more insulin, she could die. She can't wait until Tuesday. You need to have her seen first thing tomorrow.

Then, as I said, you need to look to evaluate her ongoing care. This situation is not safe.

I just got back from walking 8 miles to a 24 hr walgreens and paid out of pocket for enough to last the next 2 weeks and first thing Monday I'm going to setup an appointment with her dr and get in contact with her case manager to get her more help and I'm going to find a group or something to go to to help me learn more on how to take care of her I agree she needs more care we are going to switch her meds to walgreens since its 24 hrs. I appreciate all the input and help I'm extremely new to all this except a very small amount that you was taught when I got my cna . I will take your advice and try and get some more home care workers to come in and help with her because I really haven't been sleeping very well I'm usually up until 3 to 4 in the morning trying to get everything setup and ready to go for the next day then I get up at 630 to get the kids up and ready for school then I go back to bed until 10 am when she gets up. Its hard het husband left her because he couldn't deal with it anymore and her kids are the ones that have been trying to help her till I got here sorry about my rambling its just extremely stressful wondering if today is going to be the day that she goes to the hospital and never comes home

Sometimes it can be confusing about how much of a prescription will be filled. Usually, my doctor writes a prescription for "up to" how much insulin I will need. My prescription might say "inject as needed up to 25 units/day." If I use 25 units a day, then I would need 2.5 pens a month. But if I go to the pharmacy, the insurance may tell them to only give me 2 pens (they won't give you "extra"). So I have to go back after 20 days rather than a month. This is a hypothetical example, but is probably what has happened to your aunt. By my calculation, she uses 120 units/day and a pen lasts her 2.5 days and hence she needs 12 pens a month. That is just a little over 2 boxes. She should be getting 2-3 boxes and may be told she only gets 2 cause of insurance rules. It is quite possible that your aunt has been injecting large quantities of Lantus in an attempt to bring her blood sugar down. Lantus is quite inneffective for this purpose and she should talk to her doctor about a rapid insulin.

The real concern is that for whatever reason your aunt is not caring for herself properly and what little outside help she gets is far from sufficient. At a minimum, your aunt needs to be fully educated on what to eat (probably a low carb diet) and how to be smart and diligent about testing her blood sugar and taking her medication and insulin. If you don't get help monday, I hope you know that you can turn back to this community where members such as Zoe and others can reach out and help you,

Kayla, I’m so glad you found us. I can’t imagine how difficult it must be for you to be thrown into a situation where yoy don’t have enough information to help.

Does your aunt have any written instructions from her doctor? Is there a prescription on the boxes that you can check to be sure she’s taking the right amount of insulin?

I know how busy you are, but it would be very useful if you would keep a log of your aunt’s insulin dosages and her blood sugar with the time she tested. Can you make an appointment for her with an endocrinologist? Most have
Diabetes educators in their practices as well, someone who could help her, and you, with getting her daily management improved.

Keep us posted please. You are doing the best you can with the information you have :slight_smile:

Kayla sorry there was mo one in chat when you went. Do try again!

What about getting supplies by mail? Pump users order all equipment from medical supply houses, like CCS or Liberty. They will send a 90 day supply, as written in the doctor's orders. You can get testing supplies, insulinm syringes, etc. I am not sure about prefilled pens. Ask the doctor.

Also, ask the doctor for an undated scrip for her supplies, as the pharmacy is not being helpful. With it, you can get it filled somewhere else in and emergency without out of pocket costs.

First, make sure the doctor writed each scrip specifically. Some docs are now doing this by computer and it will contain what the computer program 'thinks' is needed. Then I would also get to the parent company or upper management of the pharmacy and complain loudly. If you have a consumer reporter on the local news, contact them also. The pharmacy should be providing the supplies as written in the scrip.

Good luck.

If you're struggling with high blood sugars you might want to try reducing the amount of carbs she eats. That doesn't mean she has to starve, but for example, instead of eating muesli and fruit salad for breakfast she could have bacon and eggs. Fewer carbs eaten means less insulin is needed, so this might be a strategy to help you get to your next refills...

Wow, eight miles! Kayla, after your first couple posts, it became more and more clear to me what a burden and responsibility you are under. I don't know how old you are or anything else about your life but I think it's truly amazing that you dropped everything to move to another state to help your aunt.

On the other hand, I'm very glad to hear you talk about getting some more help, because it sounds like an extremely difficult situation, and children being involved makes it even harder. It sounds like you have a good plan to meet with her doctor and I'm glad she already has a case manager who hopefully can take a hands on approach as well.

It sounds like you live in a rural area, but if at all possible a support group for caregivers might help you personally because this kind of caregiving is extremely draining as I know you are finding out. There are probably some online if not in the real world.

Finally, you've come to the right place for information and support about Diabetes. I believe with all my heart that the combined knowledge on here exceeds most doctors who are very far behind in Diabetes care. Don't hesitate to ask questions (in all your spare time that is! LOL). I'm glad everything is ok. I logged on and looked for this thread this morning.

Just to tailgate on Spock's post, yes, you can get vial insulin or pen insulin by mail order as well. It would be great if you could get it to the house and get 90 days worth as that would solve the problem of running out and not being able to get to the pharmacy.

This sounds like an interesting story, Her doctor has to alter her prescription.
But she does not sound to be type 1 to me. 120 units of LANTUS PER DAY?
she sounds insulin resistant like a type 2.

But in any case have her doctor change her script. He or she is the only one who can