The introduction of insulin in type 2 diabetes mellitus

Conservatively, over 1 million people have been diagnosed with diabetes mellitus in Australia, the majority with type 2 diabetes mellitus (T2DM). Until the progressive decline in pancreatic beta cell function, which characterises T2DM, can be meaningfully halted, most of these patients will require insulin therapy to maintain optimal glycaemic control over time.

The aim of this article is to provide a pragmatic overview of when and how to initiate insulin therapy for T2DM in a primary care setting.

Current Australian guidelines recommend initiating insulin therapy as once daily basal therapy or as premixed insulin. Commencement and titration of either insulin in T2DM can be conducted safely in an ambulatory care setting and it is ideal that general practitioners become familiar with this, particularly in the context of the number of people affected.