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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...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2008
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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. |
format | Text |
id | pubmed-2680733 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
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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