[Prescribing insulin in type 2 diabetes]

Insulintherapy is often the only way to obtain satisfactory glycaemic control in type 2 diabetic patients after several years of evolution of the disease. However, independently of the reluctance of the patient, it poses a few specific problems, and particularly that of weight gain initiating a vicious circle leading to deterioration of the metabolic control and to a progressive increase of insulin doses. Specific therapeutic protocols combining oral drugs and insulin have been promoted, but their efficacy is generally limited in course of time, and change to conventional or even intensified insulintherapy is in that case required. The practitioner will have to overcome his fear of using high insulin doses and give to therapeutic education the right place in order to guarantee the long term success of insulintherapy and so an effective prevention of diabetic complications.