Initiating Basal Insulin is Not Enough

Amy Butts | GAPA 2020 CME Conference

Written by: Amy Butts, PA-C, MPAS, CDE, BC-ADM

The likelihood of requiring some form of insulin therapy in type 2 diabetes increases with the duration of the disease.  As healthcare providers, it is imperative that we understand not only how to initiate basal insulin but to also titrate basal insulin.  Studies have shown that patients are initiated but then are not properly titrated.  This leads to an increase in noncompliance or discontinuation of insulin by the patient because they are not seeing the results that they thought they would.  The initiation of any basal insulin is either 10 units or 0.2 units/kg of body weight.  Setting a fasting blood glucose target with the patient is important.  Educating them on how to titrate to get to their fasting goal is imperative.  Increase basal insulin 2 units every 3 days until the fasting plasma glucose target is met.  If hypoglycemia occurs, have them decrease their dose by 1 to 2 units.  By following these simple steps you will improve outcomes for your patient and they will feel successful in controlling their diabetes.


See Amy Butts, PA-C, MPAS, CDE, BC-ADM speak at the GAPA 2020 Summer Conference in Sandestin, FL.

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