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. Discussion: 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.