By vgreene, 18 February, 2020 Efficacy, hypoglycemia risk,<sup>1</sup> and wt concerns to consider when selecting antihyperglycemic tx:
By vgreene, 18 February, 2020 Self-mixed/split insulin regimen (can adjust NPH and short/rapid-acting insulins separately)6
By vgreene, 18 February, 2020 Stepwise additional injections of prandial insulin (ie, 2, then 3 injections); then proceed to full basal-bolus regimen (ie, basal insulin and prandial insulin w/ each meal)
By vgreene, 18 February, 2020 If A1C still above target despite adequately titrated basal analog or bedtime NPH3 OR once daily basal dose 0 5 units kg OR FPG at target
By vgreene, 18 February, 2020 Otherwise, add prandial insulin.5 If adding prandial insulin to NPH: Consider a self-mixed or pre-mixed insulin regimen to decrease # of injections
By vgreene, 18 February, 2020 If on bedtime NPH: Consider converting to twice-daily NPH regimen.4 Then, if still above A1C target: Add prandial insulin as below
By vgreene, 18 February, 2020 If A1C still above target add basal insulin2 basal analog or bedtime NPH insulin