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Perspectives

Insulin and type 2 diabetes: how and when to start

Roger Chen

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Abstract

The early introduction of the concept that diabetes is a progressive disease and that escalation of pharmacological therapy is often needed is a useful manoeuvre to assist patients with the initiation of insulin.

Key Points

  • Many patients with type 2 diabetes will require insulin.
  • Basal insulins and premixed insulins can both be effective but the choice of which insulin to use will depend on the pattern of the blood glucose abnormalities.
  • Patients’ blood glucose profile should be reviewed regularly.
  • The mechanics of insulin administration can be simple but patients should be reviewed by a diabetes educator and dietitian.

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