Question of the Week | KR is Overwhelmed with Insulin Regimen
KR is a 49-year-old with a learning disability and diabetes for over 20 years and is taking the following classes of diabetes medications at maximum doses; SGLT-2, Sulfonylurea, GLP-1 RA, biguanide and a TZD. Over the past month, KR’s blood glucose levels have increased to over 300 despite a 20-pound weight loss. The endocrinologist starts KR on basal insulin plus bolus insulin at each meal based on blood glucose and carbohydrates consumed. KR arrives for their education appointment in tears, saying “I feel completely overwhelmed and confused about all this insulin stuff.”
What is the best response?
- This must seem overwhelming, but I believe that you can do this.
- Let’s review carb counting again, so you feel more confident about calculating your dose.
- Many people starting on insulin feel overwhelmed, but with time it gets easier.
- Let’s start the basal insulin first, then we can tackle the meal bolus when you are ready.
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