Insulin initiation and intensification in patients with T2DM for the primary care physician

Jeff UngerCatalina Research Institute, Chino, CA, USAAbstract: Type 2 diabetes mellitus (T2DM) is characterized by both insulin resistance and inadequate insulin secretion. All patients with the disease require treatment to achieve and maintain the target glycosylated hemoglobin (A1C) level of 6.5%&...

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Autor principal:	Unger J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/18ae5305ed3245389ab9bc85a2ed23da
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spelling	oai:doaj.org-article:18ae5305ed3245389ab9bc85a2ed23da2021-12-02T02:47:07ZInsulin initiation and intensification in patients with T2DM for the primary care physician1178-7007https://doaj.org/article/18ae5305ed3245389ab9bc85a2ed23da2011-06-01T00:00:00Zhttp://www.dovepress.com/insulin-initiation-and-intensification-in-patients-with-t2dm-for-the-p-a7749https://doaj.org/toc/1178-7007Jeff UngerCatalina Research Institute, Chino, CA, USAAbstract: Type 2 diabetes mellitus (T2DM) is characterized by both insulin resistance and inadequate insulin secretion. All patients with the disease require treatment to achieve and maintain the target glycosylated hemoglobin (A1C) level of 6.5%&ndash;7%. Pharmacological management of T2DM typically begins with the introduction of oral medications, and the majority of patients require exogenous insulin therapy at some point in time. Primary care physicians play an essential role in the management of T2DM since they often initiate insulin therapy and intensify regimens over time as needed. Although insulin therapy is prescribed on an individualized basis, treatment usually begins with basal insulin added to a background therapy of oral agents. Prandial insulin injections may be added if glycemic targets are not achieved. Treatments may be intensified over time using patient-friendly titration algorithms. The goal of insulin intensification within the primary care setting is to minimize patients&#39; exposure to chronic hyperglycemia and weight gain, and reduce patients&#39; risk of hypoglycemia, while achieving individualized fasting, postprandial, and A1C targets. Simplified treatment protocols and insulin delivery devices allow physicians to become efficient prescribers of insulin intensification within the primary care arena.Keywords: diabetes, basal, bolus, regimens, insulin analogs, structured glucose testingUnger JDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 253-261 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Unger J Insulin initiation and intensification in patients with T2DM for the primary care physician
description	Jeff UngerCatalina Research Institute, Chino, CA, USAAbstract: Type 2 diabetes mellitus (T2DM) is characterized by both insulin resistance and inadequate insulin secretion. All patients with the disease require treatment to achieve and maintain the target glycosylated hemoglobin (A1C) level of 6.5%&ndash;7%. Pharmacological management of T2DM typically begins with the introduction of oral medications, and the majority of patients require exogenous insulin therapy at some point in time. Primary care physicians play an essential role in the management of T2DM since they often initiate insulin therapy and intensify regimens over time as needed. Although insulin therapy is prescribed on an individualized basis, treatment usually begins with basal insulin added to a background therapy of oral agents. Prandial insulin injections may be added if glycemic targets are not achieved. Treatments may be intensified over time using patient-friendly titration algorithms. The goal of insulin intensification within the primary care setting is to minimize patients&#39; exposure to chronic hyperglycemia and weight gain, and reduce patients&#39; risk of hypoglycemia, while achieving individualized fasting, postprandial, and A1C targets. Simplified treatment protocols and insulin delivery devices allow physicians to become efficient prescribers of insulin intensification within the primary care arena.Keywords: diabetes, basal, bolus, regimens, insulin analogs, structured glucose testing
format	article
author	Unger J
author_facet	Unger J
author_sort	Unger J
title	Insulin initiation and intensification in patients with T2DM for the primary care physician
title_short	Insulin initiation and intensification in patients with T2DM for the primary care physician
title_full	Insulin initiation and intensification in patients with T2DM for the primary care physician
title_fullStr	Insulin initiation and intensification in patients with T2DM for the primary care physician
title_full_unstemmed	Insulin initiation and intensification in patients with T2DM for the primary care physician
title_sort	insulin initiation and intensification in patients with t2dm for the primary care physician
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/18ae5305ed3245389ab9bc85a2ed23da
work_keys_str_mv	AT ungerj insulininitiationandintensificationinpatientswitht2dmfortheprimarycarephysician
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Insulin initiation and intensification in patients with T2DM for the primary care physician

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