By vgreene, 22 February, 2019 Consider 2x or 3x daily premix insulin regimen (w/ caution re: higher risk of hypoglycemia and/or wt gain) per recommended initiation9/titration10
By vgreene, 22 February, 2019 Add prandial insulin (1 dose w/ targeted meal or meal w/ greatest PPG excursion) per recommended initiation7/titration8
By vgreene, 22 February, 2019 If above HbA1c target: Add additional basal or additional prandial insulin
By vgreene, 22 February, 2019 If still above HbA1c target: Add basal insulin per recommended initiation3/titration4
By vgreene, 22 February, 2019 Base initial tx choice on HbA1c level, presence of catabolic sx, and whether T1DM might be a possibility:
By vgreene, 22 February, 2019 If very high HbA1c (>11%) or catabolic sx (wt loss, polyuria, polydipsia) or T1DM is a possibility, consider insulin as initial injectable
By vgreene, 22 February, 2019 If HbA1c >10% but ≤11% and/or >2% above target, consider initial combo tx (GLP1-RA + basal insulin)