Clinical Approach to Medical Management of Type 2 Diabetes
Clinical Approach to Medical Management of Type 2 Diabetes
Clinical Approach to Medical Management of Type 2 Diabetes
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Insulin Initiation and Titration<br />
• Start with a Basal Insulin<br />
(<strong>Type</strong> 2 <strong>Diabetes</strong>)<br />
• Either NPH, Glargine or Detemir<br />
• Begin at 10 units or 0.2 units/Kg<br />
• Dose titration (2-3 units every 3 days) till fasting BG<br />
are in the “target range” (ADA, 70-130 mg/dl)<br />
– If hypoglycemia occurs reduce dose by 10-15% (min 4<br />
units)<br />
• If A1c is not at goal after achieving the target fasting<br />
level, add one dose <strong>of</strong> Rapid Insulin before the main<br />
meal (starting at 4-6 units)<br />
Adapted from Nathan et al, <strong>Diabetes</strong> Care, 2009
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