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Insulin for type 2 diabetes: choosing a second-line insulin regimen

Guidance has been published on the choice of initial insulin regimen for patients with type 2 diabetes [NPH (isophane) insulin or a long-acting insulin analogue] but not on how to choose a second regimen when glycaemic control becomes unsatisfactory. AIMS: To develop pragmatic clinical guidance for...

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Detalles Bibliográficos
Autores principales: Barnett, A, Begg, A, Dyson, P, Feher, M, Hamilton, S, Munro, N
Formato: Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680733/
https://www.ncbi.nlm.nih.gov/pubmed/19143853
http://dx.doi.org/10.1111/j.1742-1241.2008.01909.x
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author Barnett, A
Begg, A
Dyson, P
Feher, M
Hamilton, S
Munro, N
author_facet Barnett, A
Begg, A
Dyson, P
Feher, M
Hamilton, S
Munro, N
author_sort Barnett, A
collection PubMed
description Guidance has been published on the choice of initial insulin regimen for patients with type 2 diabetes [NPH (isophane) insulin or a long-acting insulin analogue] but not on how to choose a second regimen when glycaemic control becomes unsatisfactory. AIMS: To develop pragmatic clinical guidance for choosing a second-line insulin regimen tailored to the individual needs of patients with type 2 diabetes after failure of first-line insulin therapy. METHODS: Formulation of a consensus by expert panel based on published evidence and best clinical practice, taking into account patient preferences, lifestyle and functional capacity. RESULTS: Six patient-dependent factors relevant to the choice of second-line insulin regimen and three alternative insulin regimens (twice-daily premixed, basal-plus and basal-bolus) were identified. The panel recommended one or more insulin regimens compatible with each factor, emphasising the fundamental importance of a healthy lifestyle that includes exercise and weight reduction. These recommendations were incorporated into an algorithm to provide pragmatic guidance for clinicians. CONCLUSION: The three alternative insulin regimens offer different benefits and drawbacks and it is important to make the right choice to optimise outcomes for patients.
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spelling pubmed-26807332009-05-15 Insulin for type 2 diabetes: choosing a second-line insulin regimen Barnett, A Begg, A Dyson, P Feher, M Hamilton, S Munro, N Int J Clin Pract Consensus Guidance has been published on the choice of initial insulin regimen for patients with type 2 diabetes [NPH (isophane) insulin or a long-acting insulin analogue] but not on how to choose a second regimen when glycaemic control becomes unsatisfactory. AIMS: To develop pragmatic clinical guidance for choosing a second-line insulin regimen tailored to the individual needs of patients with type 2 diabetes after failure of first-line insulin therapy. METHODS: Formulation of a consensus by expert panel based on published evidence and best clinical practice, taking into account patient preferences, lifestyle and functional capacity. RESULTS: Six patient-dependent factors relevant to the choice of second-line insulin regimen and three alternative insulin regimens (twice-daily premixed, basal-plus and basal-bolus) were identified. The panel recommended one or more insulin regimens compatible with each factor, emphasising the fundamental importance of a healthy lifestyle that includes exercise and weight reduction. These recommendations were incorporated into an algorithm to provide pragmatic guidance for clinicians. CONCLUSION: The three alternative insulin regimens offer different benefits and drawbacks and it is important to make the right choice to optimise outcomes for patients. Blackwell Publishing Ltd 2008-11 /pmc/articles/PMC2680733/ /pubmed/19143853 http://dx.doi.org/10.1111/j.1742-1241.2008.01909.x Text en Journal compilation © 2008 Blackwell Publishing Ltd
spellingShingle Consensus
Barnett, A
Begg, A
Dyson, P
Feher, M
Hamilton, S
Munro, N
Insulin for type 2 diabetes: choosing a second-line insulin regimen
title Insulin for type 2 diabetes: choosing a second-line insulin regimen
title_full Insulin for type 2 diabetes: choosing a second-line insulin regimen
title_fullStr Insulin for type 2 diabetes: choosing a second-line insulin regimen
title_full_unstemmed Insulin for type 2 diabetes: choosing a second-line insulin regimen
title_short Insulin for type 2 diabetes: choosing a second-line insulin regimen
title_sort insulin for type 2 diabetes: choosing a second-line insulin regimen
topic Consensus
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680733/
https://www.ncbi.nlm.nih.gov/pubmed/19143853
http://dx.doi.org/10.1111/j.1742-1241.2008.01909.x
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