ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 20 Nov 2017
Last Updated on 10 Jun 2022
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This Appropriate Care Guide (ACG) highlights the importance of not delaying insulin therapy and offers a practical guide on initiating basal insulin in type 2 diabetes mellitus. It also provides evidence-based practice points on how to prevent and manage hypoglycaemia.  

First published in 2017, this ACG has been updated in 2022 to incorporate the latest evidence where relevant.

Download the PDF below to access the ACG.

Key Messages
1.Start insulin therapy if glycaemic targets are not met on non-insulin glucose-lowering agents alone.
2.Insulin therapy is usually started by initiating basal insulin (intermediate- or long-acting insulin).
3.When starting insulin therapy, review concomitant glucose-lowering agents and continue them as appropriate.
4.Educate patients and their caregivers about prevention and management of hypoglycaemia.

Initiating basal insulin in T2DM (Updated on 10 June 2022) Initiating Basal Insulin In T2DM References (June 2022)


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