Lessons in initiating insulin in clinical practice

Abstract Insulin therapy in type 2 diabetes (T2DM) can produce greater improvements in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) than oral antidiabetic drugs (OADs). There is a growing trend to recommend initiation of insulin in T2DM patients sooner in the course of the disease,...

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Veröffentlicht in:Diabetes research and clinical practice 2008-09, Vol.81, p.S16-S22
Hauptverfasser: Sharma, Surendra K, Yeo, Jing Ping, Garber, Alan
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container_title Diabetes research and clinical practice
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creator Sharma, Surendra K
Yeo, Jing Ping
Garber, Alan
description Abstract Insulin therapy in type 2 diabetes (T2DM) can produce greater improvements in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) than oral antidiabetic drugs (OADs). There is a growing trend to recommend initiation of insulin in T2DM patients sooner in the course of the disease, and good results have been achieved in insulin-naïve patients during randomised, controlled trials, often using aggressive dose titration algorithms. The Physicians’ Routine Evaluation of Safety & Efficacy NovoMix® 30 Therapy (PRESENT) study was a 6-month observational study of the safety and efficacy of biphasic insulin aspart 30 (BIAsp 30) as monotherapy or in combination with OADs in inadequately controlled patients with T2DM. This review article compares results from those patients who entered the study insulin-naïve (either with or without previous OAD treatment), with results from randomised, controlled trials of BIAsp 30 in insulin-naïve T2DM patients. It aims to provide guidance on the initiation of insulin in patients with T2DM, focusing on the efficacy of BIAsp 30 when used for this purpose, and highlighting both the low risk of hypoglycaemia associated with therapy, and the availability of delivery devices that can minimise injection site discomfort and help to overcome psychological insulin resistance.
doi_str_mv 10.1016/j.diabres.2008.06.009
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subjects BIAsp 30
Blood Glucose - drug effects
Blood Glucose - metabolism
Clinical Trials as Topic
Diabetes Mellitus, Type 2 - drug therapy
Diabetic Angiopathies - prevention & control
Endocrinology & Metabolism
Glycated Hemoglobin A - metabolism
Humans
Hyperglycemia - prevention & control
Hypoglycemic Agents - therapeutic use
Insulin - therapeutic use
Insulin analogue
Insulin initiation
Multicenter Studies as Topic
Observational study
title Lessons in initiating insulin in clinical practice
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