Insulin Therapy in Type 2 Diabetes Mellitus

Abstract

Insulin therapy is initiated for patients early in their course of diabetes to relieve symptoms of severe hyperglycaemia or in the hope of achieving remission and during the course of diabetes to attain optimal control.1,2 In the specialist outpatient setting, successful initiation of insulin therapy is very much dependent on having dedicated diabetes nurse educators (DNE) who would ensure the smooth transition of the therapy for the patient and the doctor. With the increasing prevalence of diabetes in Singapore, most patients with Type 2 Diabetes Mellitus (T2D) are now receiving their care in the community. The initiation of insulin in the polyclinics is facilitated by nurses trained in diabetes management who can assist with the initiation, optimisation and intensification of the therapy. For family practices that are not often supported by DNE, initiation of insulin therapy may be challenging. This article hopes to share some clinical pointers to help these doctors prepare their practices for their patients who require insulin therapy.