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When do you start a patient on insulin?

Duration: 03:10

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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.


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.

Learning objectives of this video is : 

1. Understanding insulin indications in Type 1 and Type 2 diabetes mellitus patients. 

Presented by Dr. Mobeen Syed

Following answers are created by ChatGPT. Occasionally the answer may be harmful, incorrect, false, misleading, incomplete, or limited in knowledge of world. Please contact your doctor for all healthcare decisions. Also, double check the answer provided by the AI below.

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