Telehealth Insulin Program: Managing Insulin in Primary Care

• We describe a safe effective approach to titrate insulin over the telephone.
• We report significantly improved glycemic control with a telehealth program.
• The case study demonstrates weekly titration using algorithms, guidelines, and protocols.
• Telehealth supports the initiation of insulin, decreasing clinical inertia for diabetics.

The telehealth insulin program (TIP) is an evidence-based approach to initiate and titrate insulin in a primary care practice. Outcomes show that TIP is effective and safe. This article describes how to initiate and titrate insulin using telehealth. Guidelines and protocols for primary care clinicians to start a telehealth program are included. With the rise in diabetes and expected increase in number of insured patients seeking primary care through the Affordable Care Act, nurse practitioners have the opportunity to support the nation’s challenge in diabetic care and be experts in insulin treatment.