primary care diabetes 4, suppl. 1 (2010) S43–S56 Contents lists available at ScienceDirect Primary Care Diabetes journal homepage: http://www.elsevier.com/locate/pcd Practical guidance to insulin management Luigi Meneghini a, *, Sara Artola b , Salvatore Caputo c , Taner Damci d , Grzegorz Dzida e , Marcel Kaiser f , Kamlesh Khunti g , Andreas Liebl h , Robert Ligthelm i , Alberto Maran j , Domingo Orozco-Beltran k , Stuart Ross l , Jean-Fran¸ cois Yale m a University of Miami Miller School of Medicine, Miami, Florida, USA b Centro de Salud Hereza I de Madrid, Madrid, Spain c Policlinico Gemelli, Universit ` a Cattolica, Rome, Italy d Istanbul University Cerrahpasa Medical School, Istanbul, Turkey e Medical University of Lublin, Lublin, Poland f Private Practice, Frankfurt, Germany g University of Leicester, Leicester, UK h Diabeteszentrum Fachklinik Bad Heilbrunn, Bad Heilbrunn, Germany i EHM Clinic Hoofddorp, Rotterdam, The Netherlands j Universit ` a di Padova, Padua, Italy k University Miguel Hern ´ andez, Sant Joan d’Alacant, Spain l University of Calgary, Calgary, Canada m McGill Nutrition Centre, McGill University, Montreal, Canada article info Keywords: Insulin initiation Insulin management Metabolic control Weight management Depression screening abstract The practical guidance to insulin management is a simple tool for health care providers, particularly primary care physicians (PCPs). Developed by experts in diabetes care at an international meeting, it aims to help physicians make key decisions to optimize insulin management and decrease long-term morbidity risk. With a growing role for PCPs in type 2 diabetes, the practical guidance focuses on confident, appropriate and timely insulin initiation. Using the acronym ‘TIME’ (Targets, Insulin, Managing weight, Encouragement and support) the practical guidance aims, in a visually appealing format, to help physicians address the challenges of insulin management with their patients, from diagnosis through insulin initiation to follow-up. © 2010 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. 1. Introduction Rising patient numbers and changes in health care policy have shifted insulin initiation in type 2 diabetes from * Corresponding author. Luigi Meneghini. Division of Endocrinology & Diabetes, University of Miami School of Medicine, Diabetes Research Institute, 1450 NW 10th Av- enue, Miami, Florida 33136, USA. Tel.: +1 305-243-5366; fax: +1 305-243-1200 E-mail address: lmeneghi@med.miami.edu (L. Meneghini). secondary to primary care. A major challenge for primary care physicians is to assimilate and utilize all relevant information regarding appropriate insulin initiation. The practical guidance presented here (reproduced on the following pages) is a simple reference tool for the clinic, reflecting insights gathered at a meeting organized by Novo Nordisk. Attended by leading experts from Europe, Canada, Israel and Turkey, the objective of this meeting was to formulate a ‘call to action’ to help physicians overcome these challenges. The practical guidance has 1751-9918//$ – see front matter © 2010 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.