BRIEF REPORT Severe Deterioration of Metabolic Control Caused by Malfunction of a Disposable Insulin Pen Device

This report describes the case of a 68-yr-old diabetic woman with severe deterioration of glycemic con-trol caused by the use of a malfunctioning insulin pen device. (J Am Board Fam Med 2008;21:575–6.) We communicate the case of a 68-yr-old woman diagnosed with type 2 diabetes with a severe met-abolic deterioration caused by the use of a defective insulin pen device. Diabetes mellitus had been diagnosed 7 years ago and had been managed by her family physician with a combination of glymepiride and insulin glargine (48 units per day). Six weeks before pre-sentation, the patient was switched to a twice-daily regimen of premixed aspart 70/30 (Novomix 30 Flexpen, Novo Nordisk)—36 units pre-breakfast and 18 units pre-dinner—to achieve further im-provement of glycemic control. Three weeks later