Questionnaire

1. What HbA1c target would you considered a pragmatic choice for this patient?

2. What treatment modifications would you consider necessary?

3. What guidance and support would you provide to the patient’s carers?

4. How would you optimise treatment to achieve an HbA_1c target of 7-7.5% as safely as possible?

5. What other potential clinical concerns does the clinician need to consider and address?

6. What other changes would you consider making to improve overall management?

7. What treatment strategies could/should be considered to reduce her experience of severe nocturnal hypoglycaemia?

8. How should the switch from IDeg Asp to Basal Insulin Igla-300 be handled?

9. What practical advice should be given to this patient to avoid nocturnal hypoglycaemia?

10. These three cases illustrate the safety of second-generation basal insulins in high risk patients with chronic kidney disease, elderly patients with complications and in patients on IDegAsp experiencing nocturnal hypoglycaemia.