Insulin Management: Insights from Diabetes Specialists

Question 1 : Previously we highlighted when insulin is needed such as A1C over 12% or that time in range is very low at less than 10%, what are some other instances where you would recommend insulin?

Question 2 : Sometimes people are reluctant to start insulin, they may have needle anxiety or now there is a kind of fear that my diabetes is getting worse or many other, what are some of the tips you would recommend to help patients overcoming some of the reluctance to start insulin?

Question 3 : Speaking of education, what are some of the tricks that you use as an educator when you are talking to patients that are reluctant to start insulin?

Question 4 : As the endocrinologist, oftentimes these patients already started insulin, so kind of take me through what you are thinking from the endocrinologist's perspective on this.

Question 5 : We know that GLP-1 receptor agonists are really becoming more commonly used for the management of type 2 diabetes, but still some individuals their fasting and post-meals HbA1c still may remain elevated, so what are you looking for when you are kind of moving beyond the GLP-1 receptor agonist and adding insulin into the regimen?

Question 6 : What do we do with all these sulfonylureas when we are starting insulin? They are still commonly used, so there is a long history. So can you just break this down, what do we do? When do we stop it, or consider keeping it on?

Question 7 : So, you are picking background insulin, I really kind of want to know what is going through your mind, you know are you thinking of maybe long-acting insulin or maybe intermediate-acting NPH insulin or one of these newer ultralong lasting insulins, so what is going through your mind clinically and with your patient?

Question 8 : From that endocriologist perspective, what is going through your mind, picking that background insulin?

Question 9 : Anything connected to nocturnal hypoglycaemia driving some of those conversations with your patient?

Question 10 : When is basal insulin not enough? And then when you need to add another therapy, is it another medication such as another insulin or another non-insulin therapy? What are your signs that basal insulin is not enough and you have to progress the therapy?

Question 11 : What are some of the things you are looking to move beyond basal insulin?

Question 12 : From the endo perspective, what are you thinking about now when you have to move beyond basal insulin?

Question 13 : From the educator perspective, where are you seeing CGM being a benefit to the patient?

Question 14 : What are your top tips that you would provide to your audience on using insulin effectively in type 2 diabetes?

Question 15 : What do you think? What are your top tips from a primary care perspective?