Association of Diabetes Care & Education Specialists

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AADE Releases Practice Paper on Insulin Initiation, Titration and Optimization

Oct 06, 2017
Insulin therapy should not be delayed for patients who don’t have the ability to achieve glycemic control despite treatment with multiple oral antidiabetic medications at maximum dose.

This was one of the take-aways from the new AADE Practice Paper, Diabetes Educators Play a Critical Role in Successful Insulin Management. It stemmed from a Sanofi US-funded thought leader summit and an AADE member survey administered to gauge educator influence and current practice.

The results included an analysis and interpretation of the practice of diabetes education related to insulin initiation and titration, the practice of insulin optimization within the U.S. based on results of the survey conducted by AADE, identification of the barriers to insulin titration and optimization in the U.S., and identification of the gaps in tools and resources for persons with diabetes and diabetes educators to achieve glycemic targets. 

According to Joanne Rinker, MS, RD, CDE, LDN, FAADE, Director of Practice and Content Development for AADE, “Diabetes educators often start insulin conversations with persons with diabetes long before it is prescribed, in an effort to increase the comfort level when their provider feels it is time to add it to their medication regimen. This paper highlights the influence diabetes educators have on the timing of initiation, intensity of titration, and how to optimize the effects.”

The bottom line:

  • Insulin therapy can improve health outcomes in persons with diabetes who need more than just lifestyle modifications and other medical therapies. 
  • Numerous barriers could impede the timely initiation and intensification of insulin therapy. 
  • Educational interventions for persons with diabetes are essential to overcome resistance to insulin initiation and long-term persistence with insulin therapy. 
  • Technologic advances and mobile health apps provide persons with diabetes and members of their healthcare team, with tools that could address some of the barriers associated with insulin initiation, titration, and long-term management. 
  • Diabetes educators play critical roles as members of multidisciplinary teams by providing ongoing education and support to persons with diabetes who require insulin therapy, including support for the use of technological advances to optimize insulin management.

Read the full Practice Paper.

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