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Use of Insulin in Outpatient Diabetes Management

  • Raquel N. Faradji
  • Ana Paula Díaz Barriga-Menchaca
  • María Elena Sainz de la Maza Viadero
Chapter

Abstract

Dosing insulin is like a dance. The insulin dose is initially calculated, and then the blood glucose levels must be evaluated, in order to increase or decrease the insulin dose responsible for that blood glucose value. The goal is not to go chasing after the blood glucose has risen but to prevent its rise. For this, one must carefully take into account the quality and quantity of a given meal (and its carbohydrate content), the activity level, the patient’s health status, and how other medications could affect the blood glucose levels.

In this chapter, we describe the different insulin types and their action times, the clinical indications for insulin initiation, the different insulin regimens, and the adverse effects. We also give insulin storage and injection recommendations.

Having a multidisciplinary team (diabetes educator, dietitian, physician, patient, family support) is key for insulin initiation and adjustment. Starting insulin in the office (first injection) will increase treatment adherence. Having a close follow-up is important. In addition, one must be careful to educate the patient in hypoglycemia prevention, detection, and treatment. It cannot be stressed out enough that self-monitoring of blood glucose (SMBG) and records are keys for a successful insulin therapy.

Keywords

Insulin Fast-acting insulin Rapid-acting insulin Intermediate-acting insulin Long-acting insulin Ultra-long-acting insulin Premixed insulin Insulin regimen Basal regimen Basal-plus regimen Basal-bolus regimen 

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Suggested/Further Reading

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Raquel N. Faradji
    • 1
    • 2
    • 3
    • 4
  • Ana Paula Díaz Barriga-Menchaca
    • 5
  • María Elena Sainz de la Maza Viadero
    • 1
    • 2
    • 6
  1. 1.Clinica EnDiMexico CityMexico
  2. 2.RENACED Diabetes Tipo 1Mexico CityMexico
  3. 3.Pathophysiology of the Endocrine System, Escuela de Medicina TEC-ABC, Tecnologico de Monterrey, Centro Medico ABCMexico CityMexico
  4. 4.Sociedad Mexicana de Nutrición y Endocrinología, MexicoMexico CityMexico
  5. 5.Instituto Nacional de Ciencias Médias y Nutrición “Salvador Zubirán”Mexico CityMexico
  6. 6.Didactic Resources for Nutrition, Escuela de Dietetica y Nutricion ISSSTEMexico CityMexico

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