Defining the role of basal and prandial insulin for optimal glycemic control.
Type 2 diabetes mellitus is a progressive disease characterized by early impairment of beta-cell function and ultimately loss of beta-cell mass. Hence, a single daily injection of a long-acting insulin is commonly initiated after intensification of oral antihyperglycemic therapy. Hemoglobin A1C should be measured every 3 months and therapy adjusted if the target is not met. As beta-cell function continues to decline, it is often necessary to add exogenous bolus insulin therapy, using short-acting insulin analogs or regular insulin. Alternatively, the use of pre-mixed insulin preparations, combining both long-acting and short-acting insulins, may be used.
Horton
Edward S
ES
Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215, USA. edward.horton@joslin.harvard.edu
D001786:Blood Glucose / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin