Type 2 diabetes - controlling hyperglycaemia with early insulin use.
BACKGROUND
Many patients with type 2 diabetes need to progress to insulin use when oral glucose lowering therapies fail to maintain adequate glycaemic control.


OBJECTIVE
To suggest when and how to initiate insulin therapy for patients with type 2 diabetes in the primary care setting.


CONCLUSIONS
In general, initiation of insulin should be considered in individuals on maximal tolerated doses of metformin and sulfonylureas with HbA1c levels >7.0% over a 3-6 month period. Current Australian guidelines recommend initiating insulin therapy as once daily basal therapy or as premixed insulins.
MacIsaac
Richard
R
University of Melbourne, Victoria. r.macisaac@unimelb.edu.au
Cheung
Ada
A
Jerums
George
G
D001315:Australia; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D045162:Thiazolidinediones / Q000627:therapeutic use
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones