When is insulin indicated in Type 2 diabetes?

Type 2 diabetes treatment goals

- HbA1c<7%

- BP <140/90

Medications used in Type 2 diabetes

- Metformin

- Thiazolidinediones (TZD-pioglitazone)

- Glucagon-like peptide 1 (GLP-1) receptor agonist (exenatide)

- Dipeptidyl peptidase-4 (DPP-4) inhibitor (sitagliptin)

- Sulphonylureas (glyburide)

- Meglitinides(repaglinide)

- Alpha-glucosidase inhibitors (acarbose)

- Insulin

When is insulin indicated in Type 2 diabetes?

- HbA1c>9% after 3 months on oral therapy

- Insulin recommended in patients with new onset of symptoms with very high glucose

- Considered if patient has ketones, renal insufficiency or other conditions like MI or surgery

- Insulin may also be prescribed to cover increased insulin needs at special times, such as during pregnancy or the stress of surgery.