title: Type 2 diabetes - controlling hyperglycaemia with early insulin use.
abstract: 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.
authors.affiliation: University of Melbourne, Victoria. r.macisaac@unimelb.edu.au
authors.forename: Richard
authors.initials: R
authors.lastname: MacIsaac
authors.forename: Ada
authors.initials: A
authors.lastname: Cheung
authors.forename: George
authors.initials: G
authors.lastname: Jerums
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones