With decreasing lengths of stay, it is only possible to provide “survival skills” education in the hospital. Patients who do not have prescription coverage will probably need to use generic oral agents and human insulin (NPH and regular) individually or premixed whenever possible. It is necessary to assess the patient's daily schedule, meal plan, insulin self-administration ability, and financial resources. For many patients with type 2 diabetes, once-daily basal insulin in combination with oral agents or twice-daily premixed insulin may be adequate. Although the use of a basal/bolus regimen is advocated in the hospital for flexibility, this regimen may not be feasible or necessary in the outpatient setting. For patients new to insulin therapy, it is important to begin education as soon as possible.
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