Start if HbA1c HASH(0x2fcfe80) 53 mmol/l (7.0 %) or above individually set target level in spite of other treatment. |
Teach the patient to perform blood glucose self-monitoring if he/she is not already able to perform it. |
Let the patient know the benefits of insulin (prevention of problems in the eyes, kidneys and nervous system). |
Diet or exercise habits do not need to be changed because of basal insulin. |
Initial dose for all patients is 10 units in the evening. |
Teach the patient to use the injection device. |
Daily monitoring of fasting blood glucose, this may be spaced out to e.g. weekly monitoring when the target has been reached. |
Teach self-adjustment: if fasting blood glucose is HASH(0x2fcfe80) 6.0 mmol/l on 3 consecutive mornings, the patient increases the dose by 2 units at home (not if fasting blood glucose is even once < 4.0 mmol/l). If the patient suffers from symptomatic hypoglycaemia, reduce the dose by 4 units. If the patient suffers from recurrent hypoglycaemia, he/she should contact his/her treatment unit. |
The dose varies between 10-200 units and is on average 70 units if a single oral drug is used (1 oral drug is equivalent to approximately 20 units of insulin). |
Basal insulin can be combined with all oral drugs; with pioglitazone, however, one should exercise caution (risk of fluid retention, not for patients with cardiac failure). |
Continuous self-adjustment of insulin dose is required for successful treatment. |
Arrange for the patient a possiblity to contact. |