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[General insulin therapy practice in type 2 diabetes mellitus]
1Abteilung Endokrinologie und Diabetologie, Departement Innere Medizin, Universitätsspital Zürich, Zürich. peter.wiesli@dim.usz.ch
Therapeutische Umschau. Revue Therapeutique
|September 19, 2002
Summary
Insulin therapy is a safe and effective treatment for Type 2 Diabetes when other methods fail. Individualized insulin regimens, including bedtime or mealtime injections, are recommended over general approaches for optimal glycemic control.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Context:
- Type 2 Diabetes (T2D) management often requires progression beyond diet, exercise, and oral agents.
- Achieving near-normoglycemia is a primary treatment objective for most T2D patients.
- Insulin therapy is a crucial, safe, and effective option when glycemic targets are unmet.
Purpose:
- To outline individualized insulin therapy strategies for Type 2 Diabetes management.
- To discuss practical approaches for initiating insulin therapy in general practice.
- To provide guidance on selecting appropriate insulin regimens based on patient characteristics.
Summary:
- Insulin therapy for T2D is safe, efficient, and should be initiated promptly when needed.
- Individualized treatment is key, with no single recommendation fitting all patients.
- Initiation may involve bedtime depot insulin with oral agents, progressing to mealtime short-acting insulin if necessary.
- A two-injection regimen with mixed insulin is an alternative if multiple injections are not feasible, but not a primary strategy.
Impact:
- Facilitates optimized glycemic control in Type 2 Diabetes patients.
- Empowers clinicians with practical strategies for insulin initiation and titration.
- Highlights the importance of personalized medicine in managing complex metabolic conditions.
- Potentially reduces long-term complications associated with poorly controlled T2D.