ACE Clinical Guidances (ACGs)

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. 

Registered doctors, pharmacists and nurses may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A/ Category V-B for reading each ACG.

*previously known as Appropriate Care Guides
Published on 20 Nov 2017
Last Updated on 29 Nov 2024
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This ACE Clinical Guidance (ACG) highlights the importance of not delaying insulin therapy for patients with type 2 diabetes mellitus and offers a practical guide on initiating basal insulin. It also provides evidence-based practice points on how to prevent and manage hypoglycaemia.  

First published in 2017, this ACG been updated in 2024 to reflect recent changes in insulin product availability and incorporate the latest evidence where relevant. 

Download the PDF below to access the ACG.
Registered doctors, pharmacists and nurses may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A/ 
category V-B for reading each ACG.

ACG Recommendations
1.Start basal insulin if glycaemic targets are not met despite optimal treatment with non-insulin T2DM medications.
2.Review concomitant T2DM medications when starting basal insulin and continue them at the current or lower dose where appropriate.
3.Educate patients and their caregivers on how to use insulin safely and effectively, including how to prevent and manage hypoglycaemia. 

Initiating basal insulin in type 2 diabetes mellitus (Nov 2024) Initiating basal insulin in type 2 diabetes mellitus references (Nov 2024)

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