4.5.0.0 In­sulin Ther­a­py

4.5.1.0 Overview

Many pa­tients with type 2 di­a­betes even­tu­ally re­quire and benefit from in­sulin ther­a­py (Fig. 9.2). See the sec­tion above, IN­SULIN IN­JEC­TION TECH­NIQUE, for im­por­tant guid­ance on how to ad­min­is­ter in­sulin safe­ly and ef­fec­tively. The pro­gres­sive na­ture of type 2 di­a­betes should be reg­u­larly and ob­jec­tive­ly ex­plained to pa­tients, and pro­viders should avoid using in­sulin as a threat or de­scrib­ing it as a sign of per­son­al fail­ure or pun­ish­ment. Rather, the util­i­ty and im­por­tance of in­sulin to main­tain glycemic con­trol once pro­gres­sion of the dis­ease over­comes the ef­fect of oral agents should be em­pha­sized. Ed­u­cat­ing and in­volv­ing pa­tients in in­sulin man­age­ment is beneficial. In­struc­tion of pa­tients in self-‍titra­tion of in­sulin doses based on self-‍mon­i­tor­ing of blood glu­cose im­proves glycemic con­trol in pa­tients with type 2 di­a­betes ini­ti­at­ing in­sulin (58). Com­pre­hen­sive ed­u­ca­tion re­gard­ing self-‍mon­i­tor­ing of blood glu­cose, diet, and the avoid­ance and ap­pro­pri­ate treat­ment of hy­po­glycemia are crit­i­cal­ly im­por­tant in any pa­tient using in­sulin.