Current State and Principles of Basal Insulin Therapy in Type 2 Diabetes

Abstract

Treatment with basal insulins is a fundamental part of management in many patients with type 2 diabetes mellitus. Multiple management schemes may be indicated in these individuals, for example, the use of oral antihyperglycemic agents with basal insulins (basal-supported oral therapy) or the combinations of basal insulins with glucagon-like peptide-1 receptor agonists; each of these strategies makes it easier to achieve glycemic control goals. A basic knowledge of the physiology, pharmacodynamic and pharmacokinetic aspects of the different basal insulins is essential to achieve treatment goals and compliance. This review addresses the principles of management with basal insulins.

Effectiveness, Simplification and Persistence of IDegLira in Poorly Controlled People with Type 2 Diabetes: A 4-Year Follow-Up Real-World Study

“…However, a caveat of an increased risk of hypoglycemia and weight gain exists. As compared to first-generation basal insulin analogues, second-generation analogues are associated with longer duration of action and low risk of hypoglycemia [ 5 , 6 ]. In parallel, GLP-1 RA increases glucose-dependent insulin secretion, decreases glucose-dependent secretion of glucagon, and slows gastric emptying and increases satiety, targeting both FPG and postprandial glycemia (PPG) [ 7 ].…”

An introduction to insulin use in type 2 diabetes mellitus

“… 8 Insulin use may also be hindered by concerns over hypoglycaemia and weight gain. 9 , 10 Thus, it is prudent that practitioners in resource-limited settings are familiar with the practical aspects of insulin therapy (initiation, intensification).…”