Guidelines For Insulin Initiation and Adjustment In Primary Care

Reviewed January 2010
Guidelines For Insulin Adjustment In Primary Care.
Education on initiating therapy should include the above points PLUS:
• Injection techniques, rotation of sites to prevent lipohypertrophy, times of
insulin administration, storage of insulin, disposal of equipment and items
available on prescription. Emphasise the need to invert the vial/pen device for
cloudy insulin at least 20 times in order to mix the insulin completely.
• Sick day rules, illness at home and alternative fluid or diet measures.
Awareness of the need to ketone test and action to take if ketonuria present.
• Glucagon administration should be taught to carers/family where appropriate.
• Eating out and appropriate information for adjusting insulin times.
• ID cards.
• Cultural considerations e.g. Ramadan
Continuing Education.
• Refer to secondary care all women requiring pre-conceptual and
pregnancy advice
• Cardiovascular risk education.
• Smoking.
• Exercise.
• Holidays and travel.
• Retinopathy screening and eye care.
• Information about annual review.
• Dental care
• Foot care.
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