Insulin Self-Titration Support in Type 2 Diabetes Patients
Keywords:
type 2 diabetes, insulin self-titration support, insulin titration, glycemic controlAbstract
Type 2 diabetes (T2D) is a chronic disease and a major health problem as the 9th rank leading cause of global deaths. Therefore, a well-controlled glycemic level within the target is essential as it is associated with a reduced risk of complications. Findings from previous literature demonstrated that self-monitoring of blood glucose and insulin self-titration were effective for glycemic control. A number of international and Thai clinical practice guidelines for diabetes have also recommended these approaches to patients with T2D. However, patients may encounter obstacles to adjust their insulin dose. In response to this problem, insulin self-titration support can help T2D patients to understand and gain confidence for insulin self-titration, achieve effective treatment, reduce the burden of healthcare professionals, and receive appropriate continual care. Although there are no specific criteria for the classification of insulin self-titration support strategies, it could be classified based on: type of the program, program duration, contact frequency, etc. Findings from previous studies also showed that several insulin self-titration support strategies can reduce glycosylated hemoglobin (HbA1c) and the risk of hypoglycemia in T2D patients. Nevertheless, other studies demonstrated contradicting effects on these outcomes in some support strategies. Currently, the most effective strategy to support insulin self-titration is yet to be determined. Hence, further comparative studies of these support strategies are warranted to inform appropriate diabetes care.
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