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Overcoming patient barriers to initiating insulin therapy in type 2 diabetes mellitus

David G Marrero1

  • 1Division of Endocrinology & Metabolism, Indiana University School of Medicine, 250 N. University Blvd., Suite 122, Indianapolis, IN 46202, USA. dgmarrer@iupui.edu

Clinical Cornerstone
|May 5, 2009
PubMed

Insights

Type 2 diabetes progressively impairs insulin production. Early insulin therapy, combined with other treatments, is more effective for glycemic control than delaying it until oral medications fail.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Type 2 diabetes is characterized by progressive beta-cell dysfunction and declining insulin secretion.
  • Most patients with type 2 diabetes eventually require insulin therapy for adequate glycemic control.
  • Current treatment strategies often delay insulin initiation due to patient and provider reluctance.

Purpose of the Study:

  • To highlight the progressive nature of type 2 diabetes and the role of insulin therapy.
  • To compare the efficacy of early insulin addition versus delayed initiation.
  • To address barriers to insulin therapy adoption.

Main Methods:

  • Review of clinical trial data on type 2 diabetes management.
  • Analysis of treatment outcomes comparing early versus delayed insulin initiation.
  • Examination of patient and provider perspectives on insulin therapy.

Main Results:

  • Adding insulin to sulfonylurea therapy is more effective when initiated before oral agents fail.
  • Maximal sulfonylurea therapy may not adequately maintain fasting plasma glucose below 108 mg/dL.
  • Patient and provider reluctance significantly delays insulin therapy modification.

Conclusions:

  • Understanding the progressive nature of type 2 diabetes is crucial for early insulin adoption.
  • Exogenous insulin is a vital therapeutic option for achieving and maintaining glycemic control.
  • Addressing concerns about insulin therapy can improve treatment adherence and outcomes.

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