title: Flexibility in insulin prescription.
abstract: This communication explores the concept of flexibility, a propos insulin preparations and insulin regimes used in the management of type 2 diabetes. The flexibility of an insulin regime or preparation is defined as their ability to be injected at variable times, with variable injection-meal time gaps, in a dose frequency and quantum determined by shared decision making, with a minimal requirement of glucose monitoring and health professional consultation, with no compromise on safety, efficiency and tolerability. The relative flexibility of various basal, prandial and dual action insulins, as well as intensive regimes, is compared. The biopsychosocial model of health is used to assess the utility of different insulins while encouraging a philosophy of flexible insulin usage.
authors.affiliation: Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Yashdeep
authors.initials: Y
authors.lastname: Gupta
authors.affiliation: Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.
authors.forename: Ambika Gopalakrishnan
authors.initials: AG
authors.lastname: Unnikrishnan
keywords: Biphasic aspart; biphasic lispro; degludec; degludec aspart; detemir; glargine; glulisine; hypoglycemia; insulin aspart; lispro; neutral protamine Hagedorn; type 2 diabetes