One month delay in FDA Release of this season’s Flu Vaccine Every year, the FDA is responsible for the analysis, review and release of every lot of Influenza Vaccine submitted by each manufacturer. This review must be completed to ensure that their product meets the necessary standards required to safely combat the flue virus. With the extensive review process, this year according to the manufacturer’s the FDA is running approximately 3-4 weeks behind schedule, which has affected the timing and release of approved flue vaccine lots to the manufacturers. With the FDA’s slower than expected release of flue vaccines, fewer approved vaccine lots have been released from the manufacturer’s, which is causing a delay in orders. We understand the importance of implementing you vaccination programs but due to the unpredictability of timing this situation, the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices recommends to schedule immunization programs toward the end of October. Be assured that we will keep you informed and as soon as our vaccines are delivered we will send your orders.
Question: Sliding Scale orders for insulin is time consuming and sometimes confusing. Is there a better way to prescribe insulin for elderly patients? Answer: According to recent guidelines published in February 2017 by the American Diabetes Association sliding-scales are NOT RECOMMENDED in long-term care. Diabetes affects up to 33% of patients in long-term care facilities The most commonly prescribed insulin therapy for patients in long-term care is sliding-scale insulin (SSI), the use of finger-stick blood glucose testing to assess the need for insulin administration based on current blood glucose levels. Its sole use for long-term treatment is specifically not recommended Recent updates to several published guidelines, including CMS, the Beers criteria, the American Medical Directors Association, and the American Diabetes Association regarding the use of SSI-only insulin regimens for elderly patients in long-term care all advise simplified treatment regimens and avoidance of “sliding-scale” regimens. Below is a summary of the recommendations: Hypoglycemia risk is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred and better tolerated. Sole use of SSI should be avoided. Liberal diet plans have been associated with improvement in food and beverage intake in this population. To avoid dehydration and unintentional weight loss, restrictive therapeutic diets should be minimized. Physical activity and exercise are