First insulin pen and fear of low blood sugar
PEBC OSCE practice station

The task

You are a pharmacist in a community pharmacy. Mrs Sunita Kapoor, aged 63, has type 2 diabetes and her doctor has started a once-daily long-acting insulin pen. She has never used insulin. She lives alone. Teach her how to use the pen, address her fears and explain what to do about low blood sugar. You may assume a demonstration pen is on the counter. The assessor will not take part in the conversation.

What this station tests

• Teach pen technique by demonstration and teach-back.
• Add-on sulfonylureas raise hypoglycemia risk with insulin; flag them to the prescriber.
• Give a clear treatment for hypoglycemia: 15 g fast sugar, recheck in 15 minutes.
• Cover driving, meals, monitoring and a plan for someone who lives alone.
• Address fears openly and provide written steps.

Sources for the clinical content

• Diabetes Canada guidelines: Chapter 14, Hypoglycemia
• Diabetes Canada guidelines: Chapter 21, Diabetes and Driving

An original practice scenario with invented patients. Not an exam question.

Practise next

• Over-the-counter request for sneezing and a blocked nose
• Starting a blood thinner for atrial fibrillation
• Another blue puffer requested within a month