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Insulin therapy in type 2 diabetes mellitus

David K McCulloch, MD
Section Editor
David M Nathan, MD
Deputy Editor
Jean E Mulder, MD


Type 2 diabetes is by far the most common type of diabetes in adults and is characterized by hyperglycemia and variable degrees of insulin deficiency and resistance. It is a common disorder whose prevalence rises markedly with increasing degrees of obesity. Treatment of patients with type 2 diabetes mellitus includes education, evaluation for microvascular and macrovascular complications, normalization of glycemia, minimization of cardiovascular and other long-term risk factors, and avoidance of drugs that can aggravate abnormalities of insulin or lipid metabolism. Weight reduction, diet, and oral medication (typically metformin) can all be used to improve glycemic control, although the majority of patients with type 2 diabetes fail to maintain glycemic targets after a successful initial response to therapy. The therapeutic options for such patients include adding a second or third oral agent or an injectable agent, including insulin, or switching to insulin.

The role of insulin in achieving optimal glycemic control in patients with type 2 diabetes will be reviewed here. Options for initial therapy, options for the management of persistent hyperglycemia, and other therapeutic issues in diabetes management, such as the frequency of monitoring and evaluation for microvascular and macrovascular complications, are discussed separately.

(See "Initial management of blood glucose in adults with type 2 diabetes mellitus".)

(See "Management of persistent hyperglycemia in type 2 diabetes mellitus".)

(See "Overview of medical care in adults with diabetes mellitus".)


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Literature review current through: Sep 2016. | This topic last updated: Jun 3, 2016.
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