Related Experiment Video
Updated: Jun 10, 2026
08:13
Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test (OGTT) and Insulin Tolerance Test (ITT)
Published on: January 7, 2018
Glycemic variability: too often overlooked in type 2 diabetes?
1Department of Family and Community Medicine, University of North Dakota School of Medicine and Health Sciences; Altru Diabetes Center, Grand Forks, ND, USA. ejohnson@medicine.nodak.edu
The Journal of Family Practice
|August 18, 2010
Summary
Consider earlier insulin introduction for diabetes management beyond HbA1c averages. Early intervention may improve long-term patient outcomes in type 2 diabetes.
Area of Science:
- Endocrinology
- Metabolic Diseases
Background:
- Glycemic control is crucial in managing diabetes.
- Hemoglobin A1c (HbA1c) is a standard measure of average blood glucose levels.
- Current treatment paradigms often delay insulin initiation.
Purpose of the Study:
- To evaluate the benefits of earlier insulin introduction in diabetes management.
- To challenge the reliance solely on HbA1c averages for treatment decisions.
Main Methods:
- Review of existing clinical guidelines and research.
- Analysis of patient data comparing early versus delayed insulin therapy.
- Exploration of factors influencing treatment timing.
Main Results:
- HbA1c alone may not fully represent glycemic variability or long-term risk.
- Earlier insulin use can lead to better sustained glycemic control.
- Delayed insulin initiation is associated with increased risk of complications.
Conclusions:
- Rethinking the threshold for insulin therapy is warranted.
- Earlier insulin introduction should be considered as a proactive strategy.
- Individualized treatment approaches beyond HbA1c targets are essential.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:26Type II Diabetes I: Introduction
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
01:24Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:26Type I Diabetes II: Pathophysiology
Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...