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Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?

Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in...

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Autores principales: Home, Philip, Riddle, Matthew, Cefalu, William T., Bailey, Clifford J., Bretzel, Reinhard G., del Prato, Stefano, Leroith, Derek, Schernthaner, Guntram, van Gaal, Luc, Raz, Itamar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131884/
https://www.ncbi.nlm.nih.gov/pubmed/24855154
http://dx.doi.org/10.2337/dc13-2743
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author Home, Philip
Riddle, Matthew
Cefalu, William T.
Bailey, Clifford J.
Bretzel, Reinhard G.
del Prato, Stefano
Leroith, Derek
Schernthaner, Guntram
van Gaal, Luc
Raz, Itamar
author_facet Home, Philip
Riddle, Matthew
Cefalu, William T.
Bailey, Clifford J.
Bretzel, Reinhard G.
del Prato, Stefano
Leroith, Derek
Schernthaner, Guntram
van Gaal, Luc
Raz, Itamar
author_sort Home, Philip
collection PubMed
description Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in such people. The group was aware of evidence that the benefits of insulin therapy are still usually offered late, and thus the aim of the discussion was how to define the optimal timing and basis for decisions regarding insulin and to apply these concepts in practice. It was noted that recent evidence had built upon that of the previous decades, together confirming the benefits and safety of insulin therapy, albeit with concerns about the potential for hypoglycemia and gain in body weight. Insulin offers a unique ability to control hyperglycemia, being used from the time of diagnosis in some circumstances, when metabolic control is disturbed by medical illness, procedures, or therapy, as well as in the longer term in ambulatory care. For those previously starting insulin, various other forms of therapy can be added later, which offer complementary effects appropriate to individual needs. Here we review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and tactics for glycemic control in type 2 diabetes.
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spelling pubmed-51318842016-12-07 Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges? Home, Philip Riddle, Matthew Cefalu, William T. Bailey, Clifford J. Bretzel, Reinhard G. del Prato, Stefano Leroith, Derek Schernthaner, Guntram van Gaal, Luc Raz, Itamar Diabetes Care Perspectives in Care Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in such people. The group was aware of evidence that the benefits of insulin therapy are still usually offered late, and thus the aim of the discussion was how to define the optimal timing and basis for decisions regarding insulin and to apply these concepts in practice. It was noted that recent evidence had built upon that of the previous decades, together confirming the benefits and safety of insulin therapy, albeit with concerns about the potential for hypoglycemia and gain in body weight. Insulin offers a unique ability to control hyperglycemia, being used from the time of diagnosis in some circumstances, when metabolic control is disturbed by medical illness, procedures, or therapy, as well as in the longer term in ambulatory care. For those previously starting insulin, various other forms of therapy can be added later, which offer complementary effects appropriate to individual needs. Here we review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and tactics for glycemic control in type 2 diabetes. American Diabetes Association 2014-06 2014-05-10 /pmc/articles/PMC5131884/ /pubmed/24855154 http://dx.doi.org/10.2337/dc13-2743 Text en © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Perspectives in Care
Home, Philip
Riddle, Matthew
Cefalu, William T.
Bailey, Clifford J.
Bretzel, Reinhard G.
del Prato, Stefano
Leroith, Derek
Schernthaner, Guntram
van Gaal, Luc
Raz, Itamar
Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title_full Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title_fullStr Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title_full_unstemmed Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title_short Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
title_sort insulin therapy in people with type 2 diabetes: opportunities and challenges?
topic Perspectives in Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131884/
https://www.ncbi.nlm.nih.gov/pubmed/24855154
http://dx.doi.org/10.2337/dc13-2743
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