Starting Insulin In Type 2 Diabetes

Feeling comfortable with treating type 2 diabetes can be overwhelming as a new grad Nurse Practitioner - and even as a seasoned Nurse Practitioner, especially if you don’t have a lot of diabetic patients in your practice. Some patients will be able to improve their diabetes and get their A1C down with lifestyle changes alone; others will need to add oral medication; others will need to add insulin to get optimal control of their diabetes.
When the time comes to have a conversation with your patient about starting insulin, they are likely to have lots of questions. If you want to be sure that you have answers, you have come to the right place. This week, we will walk through what you need to know when you have a patient who will be starting insulin for diabetes management. We’ll talk about:
✅ The other options for treating type 2 diabetes before you start insulin
✅ How much improvement you can expect with various approaches to diabetes treatment
✅ A framework for when to start insulin, and how to adjust the dose
✅ Managing hypoglycemia after starting insulin
✅ Why in-person visits are so beneficial for managing diabetes
Diabetes is a complex diagnosis for providers and patients. When you feel confused and overloaded with information, imagine how your patient feels. Being prepared for these conversations and clinical scenarios will help you to feel more confident, which will help you to be an even better resource for your patients.
✨ If you'd like support learning about how to manage Diabetes, including medication management, most recent guidelines, when to refer and examples of real-life patient cases, join us for the Managing Diabetes, Hypertension & CKD Review Course. Comes with 10.35 hours of continuing education, including 2.8 pharmacology hours, downloadable cheat sheets and lifetime access! Click here 👉 www.realworldnp.com/courses.
PLUS, grab the cheat sheet that goes along with it to keep at your desk over at www.realworldnp.com/pl/237850
If you liked this video, also check out:
👉 Chronic Care Conversations: www.realworldnp.com/blog/chro...
👉 Treating Anticoagulated Patients: www.realworldnp.com/blog/trea...
👉 Interview with A Diabetic Educator Nurse Practitioner: www.realworldnp.com/blog/diab...
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Videos I mentioned:
Hyperglycemia case study: • Hyperglycemia Workup (...
Kim Ellis Diabetes NP on KZbin: / @thediabetesnp
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Don't forget to grab your free Ultimate Resource Guide for the New NP at www.realworldnp.com/guide
More Resources:
Lab Interpretation Crash Course: www.realworldnp.com/labs
Digital NP Binder: www.realworldnp.com/binder
Diabetes Medication Workshop: www.realworldnp.com/diabetes
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[@shellyprichard809]

I LOVE your videos and your lab course!

[@RealWorldNP]

Thanks so much!!

[@carlenemcdonald94]

Thank you so much for exampling this so well.

[@RealWorldNP]

You are so welcome!

[@shayala143]

This was so helpful, thank you!!

[@RealWorldNP]

You're so welcome!

[@angelross1562]

I am a new nurse practitioner. Diabetes management is my weakness. Please do more videos on diabetes

[@RealWorldNP]

Welcome to my challenge Angel. Will definitely look at more videos on Diabetes Management.

[@adacontreras9305]

Thank you!! Please do more videos related to DM2 management 🙃

[@RealWorldNP]

Absolutely! Any topics in particular you have questions about?

[@adacontreras9305]

I would like to know more about initiating and managing other type of insulins.. do we dc some of the p.o. meds or keep it all ?

[@ddtravers1]

Please do more on DM Type II management!!!!

[@RealWorldNP]

Thanks for following - will be looking at more DM videos :)

[@joanniesilva5458]

After I initiate basal insulin for a patient who has never has it and send them to monitor FBG levels , when do they follow up?

[@RealWorldNP]

This is really patient, provider, and clinic dependent. I make sure my patients understand how to use the glucometer and tools, understand the signs and symptoms of hypoglycemia and how to administer the insulin with a needle. It's a lot to handle, so it depends on the person and if you have a diabetes educator available to help with the process. I'll do a few days, a week, 2 weeks depending on how comfortable they're feeling with it, and err on the side of sooner than later if it's all new to them. There's no hard and fast rule.

[@btpuppy2]

Please tell us how to handle a patient who has false hypos - their body has adjusted to high levels of glucose, say, 300, and it drops to 250 and they start getting sweaty, shaky, combative, all the signs a person would get under 70, and the patient lives in fear of this happening. Eating a piece of cheese or having some nuts will straighten it out but eating or drinking something sweet makes it worse. So how can you get to a lower set point where the body doesn’t have this kind of reaction? Thank you so much!

[@RealWorldNP]

I recommend these types of patients be referred to a diabetic educator. Eating every 2-3 hours can help alleviate hypoglycemic symptoms. There are other patient specific recommendations that can be made in working with provider, patient, and diabetic educator.

[@shaireedalwadi8765]

From Where can I download cheat sheet?

[@RealWorldNP]

You can download it here: www.realworldnp.com/038-opt-in

[@bebettertoday8444]

I need help!!! My husband has type 2 diabetes and it runs from 200 to 350. Sometimes higher. The other day, it was 600. I try to cook healthier meals for him, but he is keep eating all the bad foods that increase his blood sugar and he doesn’t listen. He also doesn’t want to start insulin injection. At this point, I’m almost giving up. Any advice?

[@RealWorldNP]

Hello! I am really sorry, but for legal and safety reasons I can't advise you on this. We always refer people back to their primary care providers, who are familiar with your case, and have seen your husband. I wish you all the best in this.

[@bebettertoday8444]

@@RealWorldNP thank you. I will try to do that

[@michellebrooks8243]

Where is the cheat sheet?

[@RealWorldNP]

We are having some technical difficulties with this cheat sheet's link right. If you email the RWNP team at [e-mail], we can send you a copy of this cheat sheet. Thanks for your support!