Insulin for Type 2 Diabetes: When is it Necessary?
Type 2 diabetes treatment goals- HbA1c<7%
- BP <140/90
Medications used in Type 2 diabetes
- Metformin
- Thiazolidinediones (TZD-pioglitazone)
- Glucagon-like peptide 1 (GLP-1) receptor agonist (exenatide)
- Dipeptidyl peptidase-4 (DPP-4) inhibitor (sitagliptin)
- Sulphonylureas (glyburide)
- Meglitinides(repaglinide)
- Alpha-glucosidase inhibitors (acarbose)
- Insulin
When is insulin indicated in Type 2 diabetes?
- HbA1c>9% after 3 months on oral therapy
- Insulin recommended in patients with new onset of symptoms with very high glucose
- Considered if patient has ketones, renal insufficiency or other conditions like MI or surgery
- Insulin may also be prescribed to cover increased insulin needs at special times, such as during pregnancy or the stress of surgery.
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