insulin adjustment in peritoneal dialysis

Hello,

I am a pharmacist and a CDE. In our diabetes education centre we are seeing an increasing number of patients that are on insulin and receiving peritoneal dialysis. At the diabetes centre we have a medical directive to adjust insulin doses for patients of our endocrinologists. I was wondering if anyone had any tips/guidelines/protocols that you could be willing to share with us.

Thanks!

David Leeson, B.Sc., B.Sc.Pharm., CDE
Lawson Diabetes Centre
St. Joseph's Health Care London
London, ON