Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-82

from 4.9 kg to 5.7 kg and an increase in total daily dose of 12 units to 52 units.

Recommended dosing frequency: • Pen: Dose increments of 5 units, maximum 300 units/injection 1500 units/pen. • Starting dose based on A1C: o A1C ≤8%: 20% reduction in the total daily dose. o A1C >8%: No dose reduction in total daily dose (unit-to-unit).

o Switching from basal/bolus or premixed insulins to ENTUZITY: Unit-to-unit (1:1).

• Total daily dose distribution

o Dosing BID: 60% before breakfast and 40% dinner. o Dosing TID: 40% ac breakfast, 30% ac lunch and 30% at dinner.

• Frequency: Two or three times daily based on the individual. • Administration : Given 30 minutes before a meal. • Close BG monitoring is recommended after switching and in the initial weeks.

Methods of insulin/injectable therapy administration Success in self-management can be facilitated if the person with diabetes takes an active role in the decision to initiate insulin therapy, including the treatment regimen and type of insulin. The person with diabetes should be presented with options for insulin administration that best suits their needs, abilities, lifestyle and financial situation. New devices are giving people with diabetes more choices for insulin delivery. The Forum for Injection Technique (FIT) Canada recommendations is an excellent evidence- based resource to guide best practices for insulin injections. Health-care professionals can refer to www.fit4diabetes.comfor additional information and patient education resources (150).