Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-60 important to ensure optimal insulin absorption. All people using insulin should be educated about the need to rotate injection sites in a systematic fashion. Refer to the FIT Forum for Injection Technique Canada 2017 for details: http://www.fit4diabetes.com/.

Initiating insulin therapy (24) First-line therapy : Add basal insulin to AHA therapy (type 2 diabetes) • Results in better glycemic control, reduced insulin requirements, less weight gain and hypoglycemia vs. insulin alone (24). • Average person will need >40-50 units of basal insulin to achieve FBG 4.0-7.0 mmol/L (138) When to augment insulin therapy (42) • A1C not at target, yet fasting BG levels at or near target range. • Elevated postprandial BG levels, with pre-prandial BG levels at or near target range. • Basal insulin dose >0.5 units/kg/day o Total basal doses greater than 0.5 units/kg/day associated with increased risk of hypoglycemia without significant improvement in A1C.