J Clin Outcomes Manage
2009 Mar ;16(3):127-136
Initiating insulin for type 2 diabetes: strategies for success
Vaidya A, McMahon GT
Abstract Objective: To outline a simple and evidence-based approach for initiating insulin. Methods: Algorithms for considering and approaching insulin initiation were derived from extensive literature searches and author experience. Results: Type 2 diabetes is characterized by progressive loss of beta cell function and peripheral insulin resistance. The initiation of insulin is often a pivotal intervention to avert the exposure to hyperglycemia and prevent diabetic complications. Early use of insulin may mitigate long-term consequences of hyperglycemia and can be done effectively when barriers to initiation are recognized. Conclusion: Successful insulin initiation requires an ability to elicit and navigate common barriers and misperceptions about insulin. Simple algorithms for starting and titrating insulin can be used by primary providers, with ongoing collaboration with diabetes specialists to ensure optimal management.
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