Transcription of Insulin Initiation - Dean Brown
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Insulin Initiation - Dean Brown
Visit 1 Discuss need for Insulin , including barriers to overcomeHome BG testing for 2-4wk, glucose log bookVisit 2 Review log book. Discuss adjusting oral anti-diabeticsReview barriers. Discuss Insulin . Write 3 Review. Demonstrate/teach use of Insulin pen. on injection sites, dealing with low BS, diet, dosingVisit 4 Review injection technique, review log, advise re dosingDiscuss safety issues - handoutsVisit 5 Review log, discuss problems encounteredFollow up labsInsulin InitiationInsulin InitiationPhysicianInformationPatientInf ormationPrescribing InsulinIndications for Insulin InitiationStarting InsulinStep 1 - PreparationStarting InsulinStep 2 Option ABasal +/- BolusOption BPre-mixed InsulinTesting & Insulin AdjustmentTesting & Insulin AdjustmentShort-TermFollow-upShort-TermF ollow-upLong-TermFollow-upLong-TermFollo w-up Primarily fasting/pre-meal hyperglycemia +/- post-meal hyperglycemia Preference for fewer injections Consistent daily routine Unwilling to self monitor BG Limited cognitive function Limited healthcare supportSto
Insulin Initiation Insulin may be used at almost any stage of diabetes In primary care, consider insulin if: Using 2 or more oral glucose lowering agents at or near
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