Registered Nurses' Association of Ontario

Practice Recommendations

Recommendation Level of Evidence

Recommendation 1

Nurses should assess psychosocial factors that may affect the individual’s ability to successfully initiate insulin therapy. Assessment strategies that include the use of open-ended questions to assess barriers, stressors, self-efficacy, and beliefs about insulin initiation should be used.


Recommendation 2

Education for administering insulin should be tailored in collaboration with the individual to address current knowledge, abilities, and needs.


Recommendation 3

Nurses should provide and/or reinforce appropriate teaching regarding insulin preparation and administration. Topics to include are:

  • Insulin: type, action, stability, storage, and compatibility
  • Preparation and administration of insulin
  • Sharps disposal
  • Follow-up for medical and self-care support

Recommendation 4

Nurses should encourage blood glucose self-monitoring as an integral part of daily diabetes management for individuals taking insulin. The recommended frequency of testing will vary according to diabetes treatment and the individual’s need and ability.


Recommendation 5

Individuals who self-monitor blood glucose should receive initial instruction and periodic re-education regarding self-testing technique, meter maintenance, and verification of accuracy of self-testing results.


Recommendation 6

Nurses should ensure clients taking insulin receive appropriate basic nutrition information.


Recommendation 7

Clients treated with insulin, and their caregivers, should be taught how to prevent, recognize and treat hypoglycemia.


Recommendation 8

Nurses must be aware of the effects of acute illness, surgery, and diagnostic procedures on blood glucose levels.


Recommendation 9

Nurses should provide basic education on blood glucose monitoring, dietary, and medication adjustments for periods of illness. This information should be given initially and reviewed periodically with the client.



Chronic Disease
Subcutaneous Administration of Insulin in Adults with Type 2 Diabetes
Practice Recommendations