Intensifying insulin therapy: What options are available to patients with type 2 diabetes?

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

The progressive nature of type 2 diabetes (T2D) requires practitioners to periodically evaluate patients and intensify therapy when glycemic targets become unattainable with their current treatment regimen. Traditional first- and second-line antidiabetic agents such as metformin and the sulfonylureas do not prevent the characteristic decline in beta-cell function associated with T2D; insulin replacement therapy can therefore quickly become a necessity in some patients. Basal insulin initiation provides an excellent platform to which rapid-acting prandial insulin doses can easily be added, potentially in a stepwise manner, as disease progresses. Premix insulin regimens are another effective intensification option following basal insulin initiation, but are most effective in insulin-naïve patients. The use of insulin in combination with modern T2D agents, such as the incretin-based therapies, has the potential to improve glycemic control while limiting insulin-associated weight gain and hypoglycemia. Further clinical data and approval are required before practitioners can fully endorse this novel approach.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
Volume126
Issue number9 SUPPL.1
DOIs
StatePublished - Sep 2013

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Type 2 Diabetes Mellitus
Insulin
Therapeutics
Short-Acting Insulin
Incretins
Metformin
Hypoglycemia
Hypoglycemic Agents
Weight Gain
Meals

Keywords

  • Basal insulin intensification
  • Basal plus insulin therapy
  • Basal-bolus therapy hypoglycemia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Intensifying insulin therapy : What options are available to patients with type 2 diabetes? / Meneghini, Luigi F.

In: American Journal of Medicine, Vol. 126, No. 9 SUPPL.1, 09.2013.

Research output: Contribution to journalArticle

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