Optimum management of type 2 diabetes - timely introduction, optimization and intensification of basal insulin

• Published in: Diabetes, obesity & metabolism Vol. 10; no. s2; pp. 5 - 13
• Main Author: Dailey, G
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.07.2008; Blackwell Publishing Ltd
• Subjects: Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Glycated Hemoglobin A - analysis; Humans; hypoglycaemia; Hypoglycemia - chemically induced; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - analogs & derivatives; Insulin Glargine; insulin therapy; Insulin, Long-Acting; long-acting insulin; noninsulin-dependent diabetes mellitus; type 2 diabetes
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/j.1463-1326.2008.00840.x

The natural progression of type 2 diabetes mellitus (T2DM) requires continuing medical care, early insulin intensification and patient self-management education to reduce the risk of long-term complications, including microvascular and macrovascular complications. However, too few people are on insulin, and all too commonly have poor glycaemic control. This paradigm significantly increases the risk for long-term complications. It is becoming increasingly apparent that the early introduction of basal insulin, such as insulin glargine, is essential to provide clinically important improvements in glycaemic control. In this review, we discuss the rationale for the earlier insulinization in T2DM in order to reach and maintain treatment targets and to provide further support for the recent American Diabetes Association and European Association for the Study of Diabetes consensus statement.