The many faces of type 2 diabetes.
OBJECTIVE
This report illustrates the treatment progression of a patient with rapidly decompensating type 2 diabetes.


METHODS
The patient had to transition to insulin therapy within 2 years of her initial diagnosis, following only a brief period of glycemic control with diet management, weight loss, and oral agents. This relatively rapid progression to insulin requirement is occasionally seen in adults with typical type 2 diabetes that may classify as a number of different subtypes of diabetes.


RESULTS
The case presented demonstrates how a simple stepwise approach to dose titration with basal insulin helped a patient with severe depletion of endogenous insulin achieve initial glycemic control, and how the addition of prandial insulin helped control her mealtime glycemic excursions.


CONCLUSIONS
The use of basal-prandial insulin therapy is an effective option for patients with rapidly decompensating type 2 diabetes to achieve their glycemic goals without delays and to minimize associated morbidities.
Flood
Thomas
T
Georgia Center for Diabetes, Atlanta, GA 30342, USA. sugardoctor@mindspring.com
D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008875:Middle Aged
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; C479079:insulin glulisine