The many faces of type 2 diabetes

Area of Science:

• Endocrinology
• Metabolic Disorders

Background:

• Type 2 diabetes (T2D) management can be challenging, with some patients experiencing rapid disease progression.
• Early insulin therapy is sometimes necessary for T2D patients who do not achieve glycemic control with oral agents.

Observation:

• A patient with T2D required insulin therapy within two years of diagnosis.
• Initial glycemic control was achieved with diet, weight loss, and oral agents, but this was short-lived.

Findings:

• Stepwise titration of basal insulin achieved initial glycemic control in a patient with severe endogenous insulin deficiency.
• Adding prandial insulin effectively managed mealtime glucose excursions.

Implications:

• Basal-prandial insulin therapy offers an effective strategy for managing rapidly decompensating T2D.
• This approach can help patients achieve glycemic targets promptly, minimizing associated morbidities.