Diabetes and compliance!

[monkeypharmd]

I'm having a lot of problem with a patient not injecting his insulin asparte at before he eats. Unfortunately he doesn't have family or a caregiver to watch him in the day and what he does is he injects insulin based on a sliding scale. The problem is...he says that he often "forgets" to eat right after the injection. He has been to the ER twice in the past 2 months b/c he has blacked out due to hypoglycemia.
If he injects and eats...his numbers drop nicely to with range.

What can I do for this guy? Should I drop his insulin dose b/c I know that there is a possibility of hypoglycemia? Or is there a creative method to help him to "remember" to eat after injection? A part of the problem is psych too...

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