By rray, 9 February, 2023 If A1C still above target add basal insulin2 basal analog or bedtime NPH insulin3
By rray, 9 February, 2023 Consider insulin as the 1st injectable if evidence of ongoing catabolism wt loss if hyperglycemia sx are present if very high A1C levels 10 or BG levels 300 mg dL or if T1DM dx is a possibility
By rray, 9 February, 2023 If already on GLP 1 RA or GIP GLP 1 RA or if these aren t appropriate or insulin is preferred proceed to basal insulin next step below
By rray, 9 February, 2023 Consider GLP 1 RA1 or GIP GLP 1 RA in most pts prior to insulin initiation Initiate appropriate start dose varies by agent w in class and gradually titrate to maintenance varies by agent
By rray, 9 February, 2023 To meet individual tx goals use principles from above sections including reinforcement of behavioral interventions wt mgmt physical activity and provision of DM self mgmt education and support DSMES
By rray, 9 February, 2023 To meet individual tx goals use principles from above sections incl reinforcement of behavioral interventions wt mgmt physical activity provision of DSMES