Ask The Experts
Question: How and when do I start a patient on insulin therapy? What choices of insulin regimen do I have?
Authors: Anuj Bhargava, MD, MBA, CDE, FACP, FACE.Iowa Diabetes and Endocrinology Center, Des Moines, Iowa
Type 2 diabetes mellitus (DM) is a progressive disease, and most patients will eventually need insulin. Glycemic control remains poor due to many reasons. One of the major reasons is the issue of clinical inertia, especially when initiating insulin therapy. It is estimated that, on average, a person spends ~5 years with a glycosylated hemoglobin (A1C) level >8.0% and a mean of 10 years at a level >7.0% before insulin therapy is initiated.
Type 2 diabetes mellitus (DM) is a progressive disease, and most patients will eventually need insulin. Glycemic control remains poor due to many reasons. One of the major reasons is the issue of clinical inertia, especially when initiating insulin therapy. It is estimated that, on average, a person spends ~5 years with a glycosylated hemoglobin (A1C) level >8.0% and a mean of 10 years at a level >7.0% before insulin therapy is initiated.
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