title: Insulin and type 2 diabetes. Last resort or rational management?
abstract: BACKGROUND
  Recent evidence indicates that lower glucose levels in people with type 2 diabetes result in fewer complications. People with diabetes generally have sub-optimal glycaemic control. The natural progression of diabetes is characterised by increasing glucose levels requiring increasing therapy.
  
  
  OBJECTIVE
  This article explores the possible role of therapeutic insulin in the management of type 2 diabetes. Arguments for earlier use of insulin, illustrative cases and common dilemmas faced when introducing insulin are examined.
  
  
  CONCLUSIONS
  Findings from the United Kingdom Prospective Diabetes Study (UKPDS) are reviewed. It suggests that active and aggressive management of type 2 diabetes in general practice can have a role to play in reducing complications from diabetes. It now appears that insulin has a role earlier in the management of type 2 diabetes.
authors.affiliation: Endocrine and Diabetes Service, Queen Elizabeth Hospital, Woodville, South Australia.
authors.forename: C
authors.initials: C
authors.lastname: Holmwood
authors.forename: P
authors.initials: P
authors.lastname: Philips
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002985:Clinical Protocols; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008687:Metformin / Q000008:administration & dosage; D013453:Sulfonylurea Compounds / Q000008:administration & dosage; D014652:Vascular Diseases / Q000150:complications / Q000517:prevention & control
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin