This short video identifies the patients that must receive insulin.
All type 1 diabetes mellitus patients.
Type 2 diabetes mellitus patients that fit the criteria shared in the video.
 

Notes

For the type 2 diabetes mellitus patients, here is the criteria.

a) If the first line therapy fails, then consider the second line of oral drugs. However, in case HbA1c is greater than 8.5% then consider insulin instead of another oral agent.

b) type 2 diabetes mellitus patients that fit the following criteria:

• HbA1c levels equal or greater than 9.5%.
• Fasting blood glucose levels equal or greater than 250 mg/dL.
• Random blood glucose levels greater than 300 mg/dL.
• Ketosis.
• Unexplained weight loss associated with hyperglycemia.
• A hyperglycemic patient whose status (type 1 diabetes mellitus vs. type 2 diabetes mellitus) is not known.

Further considerations:

• first line therapy is metformin.
• Assure the patient that it is not a personal failure to start on insulin. Instead, it is important to manage hyperglycemia reliably.
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