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Feature Article

Type 2 diabetes: initiating insulin in primary care

Jo-Anne Manski-Nankervis, John Furler, David O’Neal

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© BSIP/DIOMEDIA.COM
© BSIP/DIOMEDIA.COM

Abstract

The past 10 years have seen a significant increase in the therapeutic options available to people with type 2 diabetes to optimise glycaemic control. Insulin remains an important medication in the tool kit to address hyperglycaemia and reduce the risk of complications such as retinopathy, chronic kidney disease and neuropathy.

Key Points

  • Insulin can be safely initiated in the primary care setting. This may be facilitated by a multidisciplinary team that includes practice nurses and diabetes educators.
  • Key considerations when initiating insulin include addressing patient concerns about injections and ensuring patients know the equipment that they will require, including a blood glucose meter.
  • Motivational interviewing can assist in overcoming patient barriers to insulin initiation.
  • GPs, practice nurses and diabetes educators can provide advice about the management of hypoglycaemia.
  • All drivers need to be advised to contact the Driving Licence Authority in their state or territory to notify them of their commencement of insulin.
  • It is recommended that patients register with the National Diabetes Services Scheme (NDSS) at the time of diabetes diagnosis and update their registration when an injectable therapy is commenced.

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© BSIP/DIOMEDIA.COM
© BSIP/DIOMEDIA.COM