A family physician in our catchment referred Clarice* to Michelle Rigg, a Registered Nurse and one of our Certified Diabetes Educators, because Clarice’s lab work showed high A1C, despite already being on insulin and other diabetes medications.

Clarice is an elderly patient, who lives rurally, and couldn’t always get to town for an appointment – the perfect candidate for remote treatment.

Michelle called Clarice for her initial appointment and during the assessment it was apparent that she was “fuzzy” on the details surrounding her blood sugars and diet, as well as awareness of her medications. She couldn’t remember if she had taken her insulin that morning.

Michelle thought Clarice probably needed some intervention, and asked whether there were any family members who check in on her. In fact, her son Jack* came for lunch every day! Michelle arranged a phone meeting with all three of them and came up with a plan to go forward, using the son as part of Clarice’s care team.

During that call, they discovered that Clarice’s insulin and another injectable medication were being stored incorrectly and were nearing expiration. Jack was also updated that his mother’s blood sugars were high. He hadn’t been aware of these concerns previously, and was very grateful to be informed, and to have the opportunity to help. 

Michelle says, “We came up with a plan for this patient to inject her insulin every day at the same time when her son came for lunch, until follow-up could be arranged with her physician.”

The next step was Michelle collaborating with the Chronic Disease Management nurse (CRPCN’s Kaitlyn Colpoys), who informed the family physician of the findings and arranged a follow-up appointment with the physician.

Michelle suggested medication adjustments for diabetes control, as well as a home care assessment, and Kaitlyn got the ball rolling for home care.

When home care was in place, and Clarice started taking her medications regularly with support from her son and home care, her outlook improved substantially. Over the course of several diabetes follow-ups by phone with the patient and her son, Michelle is pleased to report that Clarice is showing much-improved A1C scores, and more importantly, was feeling much better.

* Names changed for privacy

What is A1C?

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.