Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-

SUCCESS OF PHARMACOLOGICAL THERAPY

Once the appropriate pharmacological regimen has been selected, the individual with diabetes and health-care team should determine a mutually agreed-upon start date for the initiation of the therapy. Education, motivation empowerment, and support are key components in facilitating success in diabetes self-management. Successful initiation of pharmacological therapy depends on a number of factors: • Access to purposeful (supported) blood glucose monitoring: o Glucose monitoring, whether capillary glucose checking or interstitial glucose sensing, provides valuable information on the effect of insulin/medication, food and exercise on the person’s BG level. o Insulin/medication dose adjustment will be based on the individual’s glucose monitoring metrics. • Guidelines for initiating pharmacological therapy, including detailed instructions outlining the following: o Timing of antihyperglycemic agents/insulin administration. o individualized goal-setting of BG and A1C targets through engaged shared-decision making o Prevention, recognition and treatment of hypoglycemia, if applicable (i.e. if starting an AHA associated with hypoglycemia) o Steps to identify patterns in BG results (see Chapter 12: Basal-Bolus Insulin Therapy). o Need to contact the DHC team when problems in glycemic control have been identified, or instances of severe hypoglycemia or hyperglycemia. o Sick-day management guidelines (see Chapter 8: Acute Complications). o Need to make adjustments in anticipation of exercise to prevent or minimize risk of hypoglycemia (decrease insulin dose or increase carbohydrate intake). • Ongoing education and support: o Education and support are an integral component of the treatment plan, and absolutely essential for facilitating diabetes self-management and helping people with diabetes achieve their optimal level of glycemic control.

o People with diabetes must be empowered to identify the need to augment pharmacological therapy or make changes to their insulin dose based on