Patient Self-Adjustment of Insulin
DCPNS Patient Self-Adjustment of Insulin Working Group
Since 2014, the DCPNS has been working to improve patient self-adjustment of insulin. We know that many individuals have difficulty achieving target blood glucose values. Data from the DCPNS Registry helped to guide this work demonstrating that people using insulin therapy have the greatest difficulty achieving A1C targets and we know that self-adjustment may be one of the reasons.
Diabetes Centres’ health care providers were surveyed in 2015, and findings reinforced the need for tool/resource development to help standardize the approach to patient self-adjustment of insulin and to assist with assessing readiness. In 2015, we formed a working group with diabetes educator representation from across the Province and distributed a survey to persons with diabetes who had used insulin for ≥ 6-months to gather information on adjustment practices, reasons for adjusting, and factors that help or hinder adjustment. See the abstracts presented at Diabetes Canada (former Canadian Diabetes Association) Conferences in 2015 and 2016, outlining the survey processes and findings.
Under the leadership of Carrie Haggett (former DCPNS Diabetes Consultant) and with the assistance of Michael Vallis, PhD, tools have been developed and some pilot testing has taken place.
Tools in the Patient Self-Adjustment of Insulin Toolkit include an algorithm that assists educators in determining patient ability/readiness to self-adjust, with associated tools that are used at various decision points as well as videos to assist HCP and persons with diabetes.
- Algorithm: Do you understand what you have been asked to do with adjusting your insulin?
- Am I Ready to Adjust My Insulin? A patient self-assessment questionnaire
- Insulin Attitude Worksheet (HCP version, with response cues)
- Insulin Attitude Worksheet, for self-completion by persons with diabetes
- Readiness Assessment questions (for HCP use)
- Insulin adjustment instruction worksheets: Parts 1 (Getting Started), 2 (When Starting One Insulin Only), and 3 (When Starting on a Mealtime Insulin) for persons with diabetes