Home' Australian Pharmacist : Australian Pharmacist October 2015 Contents Australian Pharmacist October 2015 I ©Pharmaceutical Society of Australia Ltd.
1. Patient reluctance to commence
insulin therapy with type 2 diabetes
could could be due to a view that:
a) Insulin is not an effective treatment for
b) They are a failure due to lack of self
c) Insulin is never required to manage
type 2 diabetes.
d) There are no insulin preparations
subsidised via the PBS for type 2
2. Advances in injection technique have
a) Use of pen devices.
b) Injection site rotation.
c) Improved needle technology.
d) All of the above.
a) Is due to repeated injection into the
b) Is usually avascular or has minimal blood
c) Can lead to erratic or delayed
absorption of injectable therapy.
d) All of the above.
4. Alternative modes of delivery of
injectable therapies can:
a) Reduce anxiety & fear around injections.
b) Improve adherence to therapies.
c) Lead to improved glycaemic control.
d) All of the above.
5. Which of the following is correct with
regard to subcutaneous injection
a) They reduce the number of skin
b) They negatively affect the person’s
c) They can be used for intramuscular
d) They can be worn for 5 days.
Answer online at www.psa.org.au
CONTINUING PROFESSIONAL DEVELOPMENT
It is worth a discussion with the patient
around their private health cover if they
are considering insulin pump therapy.
New devices and technology may assist
in alleviating barriers to commencing
insulin or injectable therapies but
will not provide all the answers.
The beliefs of the healthcare providers
can positively or negatively affect the
patient’s beliefs, therefore it is important
that healthcare providers give patients
the information and support they
need to help alleviate unnecessary
distress. If a pharmacist is uncertain
how a patient may be progressing
with their diabetes self-management,
then utilising tools such as the PAID
questionnaire15 may help determine
whether a referral to their diabetes
care team is required urgently.
Pharmacists are an important part of
the patient’s diabetes healthcare team
because they have regular contact
with patients, especially at collect of
prescriptions. A simple discussion
around ‘how are you going with your
diabetes medicines’, without focussing
on numbers or targets, may help identify
patient concerns that can be addressed.
1. Galli-Tsinopoulou A. Insulin therapy in children and
adolescents with diabetes. Diabetes Res Clin Prac
2. Given J, McCay D, Hill A et al.. Understanding barriers to
commencing injectable therapy in people with type 2
diabetes. J Diabetes Nurs 2015;19(6):214–20.
3. Fulcher G, Roberts A, Sinha Aet al. What happens when
patients require intensification from basal insulin? A
retrospective audit of clinical practice for the treatment of
type 2 diabetes from four Australian centres. Diabetes Res
Clin Prac 2015;108:405–13.
4. Diggle J. Are you FIT for purpose? The importance
of getting injection technique right. J Diabetes Nurs
5. Akhrass F, Skinner N, Boswell K et al. Evolving trends in
insulin delivery: In pursuit of improvements in diabetes
management. AHDB 2010;3(2):117–22.
6. Peyrot M, Rubin R, Lauritzen Tet al. Resistance to insulin
therapy among patients and providers. Diabetes Care
7. Australian Diabetes Educators Association (ADEA). Clinical
guiding principles for subutaneous injection technique.
8. Blanco M, Hernandez MT, Strauss Kat al. Prevalence and risk
factors of lipohypertrophy in insulin injecting patients with
diabetes. Diabetes & Metab 2013;39(5):445–53.
9. Clapham L. Injection technique education and follow-up:
The key to ensuring optimal glycaemic control. J Diabetes
10. Dokken BB. Optimizing technology for diabetes care.
Clinical Advisor. 2012.
11. Benroubi M. Fear, guilt feelings and misconceptions:
Barriers to effective insulin treatment in type 2 diabetes.
Diabetes Res Clin Prac 2011;93S:S97–S9.
12. Korytkowski M. When oral agents fail: practical barriers to
starting insulin. Int J Obes 2002;26(Suppl 3 ):S18-S24.
13. Frid A, Hirsch L, Gaspar R et al.. The third injection technique
workshop in Athens ( TITAN). Diabetes & Metab 2010;36,
14. Burdick P, Cooper S, Horner B et al. Use of a subcutaneous
injection port to improve glycaemic control in children
with type 1 diabetes. Pediatr Diabetes 2009;10:116–9 .
15. Snoek FJ, Welch GW. Problem Areas in Diabetes
Questionnaire (PAID). Novo Nordisk, 2006. At: http://www.
16. Welch GW, Jacobson AM, Polonsky WH. The Problem
Areas in Diabetes Scale: An evaluation of its clinical utility.
Diabetes Care 1997;20(5):760–6 .
Links Archive Australian Pharmacist September 2015 Australian Pharmacist November 2015 Navigation Previous Page Next Page