Insulin initiation and intensification: Insights from new studies

  • Kumar A
  • Kalra S
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Abstract

Tight glycemic control is central to reducing the risk of long-term macrovascular and microvascular complications of type 2 diabetes and the associated morbidity and mortality. However majority of the patients do not achieve glycemic targets ({HbA1c} < 7%). Once insulin treatment has been initiated, each patient's regimen must be optimized and intensified to reach the target. In many guidelines, initial insulin therapy comprises a single dose of long-acting insulin or premixed insulin. Basal insulin will help to control fasting plasma glucose ({FPG}) level, but postprandial glucose excursions make a significant contribution to the overall daily hyperglycemia of type 2 diabetic patients. {BIAsp} 30 is the most prescribed analog premix and consequently has the largest evidence base in terms of randomized controlled trials ({RCTs}) and observational data. It follows that {BIAsp} 30 is therefore the analog premix most likely to be used for insulin intensification, both from basal insulin and from {BIAsp} 30 regimens: {OD} to {BID} and from {BID} to {TID}.

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  • SGR: 80051572749
  • PUI: 368981685
  • SCOPUS: 2-s2.0-80051572749
  • ISSN: 00045772
  • PMID: 21818994

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