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Insulin therapy in type II diabetes
1Diabetes Research Laboratories, Radcliffe Infirmary, Oxford, UK.
Diabetes Research and Clinical Practice
|August 1, 1995
Summary
Adding basal insulin supplements can help manage blood glucose levels when diet alone is insufficient. This approach is effective for both insulin deficiency and resistance, minimizing hypoglycemia risks and allowing normal lifestyles.
Area of Science:
- Endocrinology
- Metabolic Diseases
Background:
- Diet therapy is the first line of treatment for type 2 diabetes.
- When diet alone is insufficient to control fasting plasma glucose (FPG) levels below 6 mmol/L, pharmacological intervention is necessary.
Purpose of the Study:
- To evaluate the efficacy and safety of basal insulin supplementation as an alternative to oral hypoglycemic agents.
- To determine the optimal dosing strategy for basal insulin based on FPG and obesity levels.
Main Methods:
- Retrospective analysis of patient data comparing basal insulin to sulfonylureas and metformin.
- Dose prediction models for basal insulin based on FPG and obesity index.
- Assessment of hypoglycemia risk and impact on lifestyle.
Main Results:
- Basal insulin dose can be predicted by FPG and obesity, indicating insulin resistance.
- Hypoglycemia risk is minimal when doses are adjusted to FPG levels.
- Basal insulin does not cause significant weight gain and supports normal lifestyle.
Conclusions:
- Basal insulin supplementation is a safe and effective strategy for managing type 2 diabetes when oral agents fail or are contraindicated.
- It is suitable for patients with both insulin deficiency and insulin resistance.
- In elderly patients with irregular meal patterns, basal insulin combined with sulfonylureas can prevent hyperglycemia.