Helping Patients Understand Their Insulin Regimens
Explaining Insulin
Giving patients a brief overview of how insulin works may help when setting their
expectations for insulin therapy. Patients with type 2 diabetes may have questions
about their therapy,49-51 and a quick lesson on the basics may help
them to better understand insulin treatment.
Reassurance
Some patients may find it difficult to cope with the news that they need insulin
therapy. They may be confused by their insulin regimens, and may perceive it as
a punishment for having failed to control their blood sugar. They may not be aware
of the potential benefits and realistic risks associated with insulin use.
Reassuring patients about their insulin therapy may involve:
- Making them feel supported
- Not making them feel judged
- Helping them prepare for future office visits
Supporting Patients
Helping patients feel comfortable with their insulin therapy may involve providing
them with education on:
- Proper insulin usage and storage
- Preparation of testing equipment
- Prepping for and performing finger sticks
- Keeping notes of their results
- Prepping the injection site and self-injecting
- Cleaning equipment and disposing needles
- Recognizing and managing side effects
Encouraging and Managing Patients
Helping patients understand their insulin therapy may mean taking an instructive,
educational role at times. Some patients may have barriers to learning about insulin
therapy, including a lack of knowledge about diabetes, misperceptions about insulin,
injection fears, and other concerns, including difficulty understanding dosage and
titration instructions.51
In fact, a survey showed that 46% of patients misinterpret dosage instructions of
one or more medications.52
Physicians may be able to help patients reach a better understanding of their insulin
therapy by:53
- Being patient during appointments and speaking slowly
- Avoiding complicated language
- Using visual aids such as pictures or videos
- Simplifying and repeating explanations and instructions
- Using a "teach back" or "show me" approach to confirm understanding
- Having the patient explain information back to you to ensure he or she understands
When talking about LANTUS® with patients, the Patient Web site and other patient-related materials may
be useful assets.
Switching patients
to LANTUS® >
CONTRAINDICATIONS
Lantus® is contraindicated in patients hypersensitive to insulin glargine or
one of its excipients.
WARNINGS AND PRECAUTIONS
Monitor blood glucose in all patients treated with insulin. Insulin regimens should
be modified cautiously and only under medical supervision. Changes in insulin strength,
manufacturer, type, or method of administration may result in the need for a change
in insulin dose or an adjustment in concomitant oral antidiabetic treatment.
Do not dilute or mix Lantus® with any other insulin or solution. If mixed or
diluted, the solution may become cloudy, and the onset of action/time to peak effect
may be altered in an unpredictable manner. Do not administer Lantus® via an
insulin pump or intravenously because severe hypoglycemia can occur. Insulin devices
and needles must not be shared between patients.
Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®,
and may be life-threatening.
Severe life-threatening, generalized allergy, including anaphylaxis, can occur.
A reduction in the Lantus® dose may be required in patients with renal or hepatic
impairment.
DRUG INTERACTIONS
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and
close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients
taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and
reserpine).
ADVERSE REACTIONS
Other adverse reactions commonly associated with Lantus® are injection site
reaction, lipodystrophy, pruritus, and rash.
Lantus® SoloSTAR® is a disposable prefilled insulin pen. To help ensure
an accurate dose each time, patients should follow all steps in the Instruction
Leaflet accompanying the pen; otherwise they may not get the correct amount of insulin,
which may affect their blood glucose.
Lantus® is a long-acting insulin analog indicated to improve glycemic control
in adults and children (6 years and older) with type 1 diabetes mellitus and in
adults with type 2 diabetes mellitus. Lantus® should be administered once a
day at the same time every day.
Important Limitations of Use: Lantus® is not recommended for the treatment of
diabetic ketoacidosis. Use intravenous short-acting insulin instead.
Lantus® SoloSTAR® is a disposable prefilled insulin pen.
Please click here for full prescribing information.
CONTRAINDICATIONS
Apidra® is contraindicated during episodes of hypoglycemia and in patients hypersensitive
to Apidra® or any of its excipients.
WARNINGS AND PRECAUTIONS
Closely monitor blood glucose in all patients treated with insulin. Change insulin
regimens cautiously and only under medical supervision. Changes in insulin strength,
manufacturer, type, or method of administration may result in the need for a change
in insulin dose or an adjustment in concomitant oral antidiabetic treatment. As
with all insulin preparations, the time course of Apidra® action may vary by
individual or at different times in the same individual and is dependent on many
conditions, including the site of injection, local blood supply, or local temperature.
Hypoglycemia is the most common adverse reaction of insulin therapy, including Apidra®,
which may be serious.
Severe life-threatening, generalized allergy, including anaphylaxis, can occur.
All insulins, including Apidra®, can cause hypokalemia, which if untreated,
may be serious.
A reduction in the Apidra® dose may be required in patients with renal or hepatic
impairment.
Apidra® for subcutaneous injection should not be mixed with insulins other than
NPH. Do not mix Apidra® with any insulin when used in the pump or for intravenous
administration. Insulin devices and needles must not be shared between patients.
DRUG INTERACTIONS
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and
close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients
taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and
reserpine).
ADVERSE REACTIONS
Other adverse reactions commonly associated with Apidra® include injection site
reactions, lipodystrophy, pruritus, and rash.
Apidra® is a rapid-acting insulin analog indicated to improve glycemic control
in adults with type 2 diabetes or adults and children (4 years and older) with type
1 diabetes.
When used as a mealtime insulin, the dose of Apidra® should be given within 15 minutes
before or within 20 minutes after starting a meal. Apidra® given by subcutaneous injection
should normally be used in regimens that include a longer-acting insulin.
Please click here for full prescribing information for Apidra®
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