Insulin Therapy in Diabetes Management
A new set of guidelines, endorsed by the NHMRC, was published recently by Diabetes Australia and the RACGP.
The National Diabetes Services Scheme (NDSS) offers people with diabetes access to diabetes-related products such as blood glucose testing strips, and insulin pump consumables at heavily subsidised prices and free insulin needles and syringes.
If you have a patient with diabetes, register them with the NDSS and assist them to manage their diabetes. Registration is free and done only once.
Blood glucose monitoring is recommended for all people with type 2 diabetes. Self-monitoring needs to be individualised. Monitoring in type 2 diabetes need not be as intensive as with type 1 diabetes except when the normal pattern is broken, such as when travelling, during the festive season, when there is intercurrent illness, or when there have been changes to medication and diet.
Multiple interventions and medications are needed to control the multiple risk factors associated with type 2 diabetes, including hyperglycaemia, hypertension, dyslipidaemia and increased thrombogenesis. Medication will not substitute for healthy eating and activity.
Premixed as well as basal insulin may be required if adequate control has not occurred on maximum doses of oral hypoglycaemic agents.
People with type 2 diabetes requiring insulin can often be managed with a single daily dose of premixed, intermediate or long-acting insulin added to their oral hypoglycaemic schedule.
Syringes are the most commonly used device for delivering insulin.
Insulin pens make injections much simpler since drawing up is unnecessary. They also allow people to be more flexible in their self-management. Recent research demonstrated excellent dosing accuracy of insulin pens.
Diabetes Australia: www.diabetesaustralia.com.au, phone 1300 136 588
National Diabetes Services Scheme: www.ndss.com.au
The Diabetes Centre: www.diabetes.org.au, phone (08) 8222 6771