Essential aspects of successful insulin therapy By Dr Om Lakhani

Introduction:
The speaker, Dr. Om Lakhani, begins by expressing gratitude to the organizers of a conference on insulin therapy. He highlights the importance of dosing, titration, storage, and transport in successful insulin therapy.
Patient Case Study:
He shares a case study of a 35-year-old patient diagnosed with diabetes, emphasizing the need for insulin therapy. The patient initially resists insulin treatment, but the speaker convinces him by explaining the long-term benefits and the increased mortality rate of uncontrolled diabetes, especially during the COVID-19 pandemic.
Insulin Dosing:
The speaker discusses the challenges of determining the right insulin dose. He refers to various product monographs and recommends a starting dose of 10 units for most patients. However, he argues that the actual requirement is often higher, around 25 units on average.
Titration and Study:
He presents a study conducted on hospitalized patients to determine the correlation between basal insulin dose and various parameters. The study concludes that higher HbA1c levels require more insulin, and Indian patients may need higher doses than recommended.
Fixing Fasting Sugar:
The speaker explores whether fixing fasting sugar with strategic use of insulin is enough to achieve target glucose control. He presents an ongoing study that suggests that this approach is effective in 80% of patients, with a mean dose of 28 to 30 units.
Titration Frequency:
He challenges the guideline of titrating every three to seven days, advocating for daily titration with a target of 90 to 140. He emphasizes the importance of physician-led titration and shares a WhatsApp-based titration method used in his practice.
Injection Technique:
The speaker stresses the importance of proper injection technique, including site rotation and needle change. He warns against the common practice of reusing needles and shows images to illustrate the damage caused by repeated use.
Storage and Transport:
He provides guidelines for storing insulin at the correct temperatures and emphasizes the importance of proper storage during travel. He also mentions unique storage solutions for those without access to refrigeration.
Conclusion:
The speaker summarizes the key points, emphasizing the need to read product monographs, consider higher starting doses, titrate daily, use proper injection techniques, and store insulin correctly. He thanks the audience and opens the floor for a panel discussion.

[@mohamedalfahad268]

Thanks alot ❤