Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-

GETTING STARTED ON INSULIN THERAPY

Prior to initiation of insulin therapy, the person with diabetes and/or their caregiver should receive the following information to help ensure success in insulin therapy and empower the individual/caregiver to take an active role in their diabetes self-care: • Written instructions on the name of the insulin, starting dose(s), and timing of administration. • Setting realistic expectations with people/caregivers to support success (138). o Reminder that the starting dose is not the correct dose.

o Timely titration of doses is essential to reach glycemic targets. o Provide a simple titration algorithm to self-adjust the insulin dose. ▪ i.e. Written instruction: Increase dose by units every

day until

waking blood sugar is less than

. Reduce dose by 2 units if

waking blood sugar is less than 4.0 mmol/L.

• glucose monitoring frequency/data capture and individualized glucose targets (before meals / after meals)/metrics • Hypoglycemia: Signs, symptoms and treatment. • Discuss strategies to minimize/prevent adverse effects such as weight gain and /or hypoglycemia. • Guidelines on when to contact the DHC team: Presence of hypoglycemia, significant hyperglycemia, or blood glucose levels remain above the individuals’ BG target. • Arranging timely follow up appointment(s) with individual/caregiver for initial and ongoing insulin dose adjustment until glycemic targets are met.