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[Initiation of insulin therapy for type 2 diabetes mellitus]

M B Antsiferov1

  • 1Moscow endocrinology dispensarium.

Problemy Endokrinologii
|October 2, 2019
PubMed

Insights

Early basal insulin (Lantus) combined with oral hypoglycemic agents (OHA) effectively manages decompensated diabetes mellitus. This approach rapidly improves glycemic control (HbA1c) within 12 weeks without increasing hypoglycemia risk.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacotherapy

Context:

  • Type 2 diabetes mellitus often requires multifaceted treatment strategies.
  • Many patients do not achieve glycemic targets with oral hypoglycemic agents alone.
  • Insulin therapy is frequently necessary for advanced or poorly controlled diabetes.

Purpose:

  • To evaluate the efficacy and safety of early basal insulin (glargine) initiation in patients with diabetes mellitus resistant to oral hypoglycemic agents (OHA).
  • To assess the impact of combined OHA and basal insulin therapy on glycemic control (HbA1c) and hypoglycemia risk.

Summary:

  • A study analyzed data from 2895 patients with diabetes mellitus inadequately controlled by OHA.
  • Initiation of basal insulin (Lantus) alongside OHA significantly improved carbohydrate metabolism and lowered HbA1c levels within 12 weeks.
  • The combined treatment demonstrated a rapid and safe achievement of optimal glycemic parameters without an increased risk of hypoglycemia.

Impact:

  • Early introduction of basal insulin glargine can be a beneficial strategy for patients with decompensated diabetes mellitus.
  • This therapeutic approach allows for rapid and safe attainment of target glycemic control.
  • Supports evidence-based guidelines for intensifying diabetes management when oral agents are insufficient.
Keywords:
diabetes mellitusglargine insulinglycated hemoglobinhypoglycemic statesobservational program to monitor glycated hemoglobin levels

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