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Early use of insulin in T2DM

May 7, 2008

Regrettably we do do delay initiation of insulin in our T2DM patients. Reasons may be patient or physician related.  

Consider insulin in patients who do not need meet glycemic targets even after life style changes and maximal Oral Hypoglycemic drugs.
Key messages from this practice review are:

Key messages

  • Early and continuing lifestyle interventions decrease disease progression
  • Initiate insulin early by adding night-time basal insulin to oral antidiabetic agents
  • Ensure metformin is part of ongoing therapy and use of thiazolidinediones does not delay progression to insulin
  • Review use of thiazolidinediones in heart failure and ischaemic heart disease

3 comments:

Anonymous said...

is there any guideline on initiating night basal insulin?Dont we need to monitor night time sugar levels after initiation? ?? risks of Hypos

arif said...

Did you not read the practice review?

Anonymous said...

sorry missed it. read it and found a very practical guide to initiation especially the steps on dose titration thank you