title: [Optimizing basal insulin therapy in type 2 diabetes].
abstract: Because of the natural history of type 2 diabetes and the increasing life expectancy, more and more patients are treated with insulin after failure of oral therapy. International guidelines give the preference to basal insulin, most often while maintaining metformin. If this treatment does not allow to reach the glycaemic objectives, optimizing therapy is mandatory. This clinical case offers the opportunity of discussing both advantages and disadvantages of three therapeutic options : the shift from basal insulin to a basal-plus or a basal-bolus insulin regimen, the addition of another oral glucose-lowering agent, either a dipeptidyl peptidase-4 inhibitor (gliptin) or an inhibitor of cotransporters sodium-glucose type 2 cotransporters (gliflozin), or the combination of basal insulin and a glucagon-like peptide-1 receptor agonist.
authors.affiliation: Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU de Liège, Site Sart Tilman, Liège, Belgique.
authors.forename: A J
authors.initials: AJ
authors.lastname: Scheen
authors.affiliation: Service de Diabétologie, Nutrition et Maladies métaboliques, CHU de Liège, Site Sart Tilman, Liège, Belgique.
authors.forename: N
authors.initials: N
authors.lastname: Paquot
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D000077203:Sodium-Glucose Transporter 2 Inhibitors
keywords:  Basal insulin ;  DPP;  GLP;  SGLT2 inhibitor ;  Type 2 diabetes ; 1 receptor agonist ; 4 inhibitor ; Basal; bolus regimen 