Intensification in the management of Type 2 Diabetes Mellitus (T2DM) using insulin in family practice

ABSTRACT

Background@#Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease leading to target organ complications over time. The delays in treatment and glycemic control have significant implications in short and long-term health outcomes resulting in increased healthcare resource utilization thus timely insulin initiation and intensification is recommended@*Objective@#This clinical pathway was developed to guide family and community physicians on how to intensify the treatment of Type 2 Diabetes Mellitus (T2DM) using insulin intended for patients who require insulin initiation or titration@*Methods@#The PAFP Clinical Pathways Group reviewed published literature in order to identify, summarize and operationalize the evidence in the management of T2DM patients on insulin use in family and community practice. The recommendations are time bound tasks on patient care processes, in terms of history and physical examination, laboratory tests, pharmacologic and non-pharmacologic interventions and patient outcomes@*Summary of Recommendations@#The recommendations on clinical history and physical examination, laboratory, pharmacologic interventions, non-pharmacologic interventions subdivided into patient-centered, family-focused and community-oriented and patient outcomes are grouped into first visit and second visit, continuing visits