Multiple-dose insulin injection therapy in patients with type 2 diabetes using a basal-bolus regimen, team management, and nutrition education

• Published in: Dubai diabetes and endocrinology journal Vol. 13; no. 3; pp. 141 - 146
• Main Author: Rizvi, Ali A.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.03.2019
• Subjects: Further Section; nutrition education; type 2 diabetes; team management; insulin treatment; carbohydrate counting; basal-bolus therapy
• ISSN: 2673-1797; 1606-7754; 2673-1738; 2073-5944
• DOI: 10.1159/000497582

We determined the efficacy of basal-bolus insulin therapy delivered through team education and nutrition counseling for management of type 2 diabetes in 17 patients treated with a regimen of once-daily insulin glargine and either insulin aspart or lispro three times a day. They received written instructions and specific education about ‘basal-bolus’ insulin administration, use of a ‘forced-titration’ schedule for glargine dose adjustment, and calculation of rapid-acting pre-meal bolus insulin. The average hemoglobin A1c level decreased from 8.7 ± 2.06% to 7.0 ± 1.07%, a significant reduction of 1.7% (p<0.05) over 3 months or more. 7 patients (41%) reported improvement in hypoglycemic events. In conclusion, an intensive multidose basalbolus insulin treatment using self-titration and flexibility through carbohydrate counting confers beneficial effects in patients with type 2 diabetes, including better glycemic control and reduced hypoglycemia. These results are best achieved through multi-disciplinary patient care involving the nurse educator and dietician as part of a diabetes care team. (Int J Diabetes Metab 13:141-146, 2005)