Intensification with prandial insulin.
Int J Clin Pract. 2009 Oct;63(s164Insulin Intensification Summit):11-14
Authors: Pfützner A, Forst T
Aims: Many patients with type 2 diabetes will ultimately need insulin therapy to maintain their target for glycaemic control. This review considers how best to achieve the target for glycaemic control in primary care. Methods: Literature review and workshop discussions among participants at the Insulin Intensification Summit. Results: Treatment aimed at reducing postprandial glucose is more effective in improving glycaemic control near target levels. Adding prandial doses of a short-acting insulin is superior to switching to a twice-daily premixed insulin. Short-acting analogue insulins offer advantages over animal insulins for intensification of basal insulin therapy, which can be achieved either by sequentially adding prandial doses or immediate introduction of three-times daily prandial dose. Each approach has benefits depending on the health care system and can be supported in primary care by a simple algorithm. Conclusion: Intensification of basal insulin therapy is most effectively achieved by adding a prandial short-acting insulin analogue, using a simple clinical algorithm. The regimen should be selected according to local needs.
PMID: 19930415 [PubMed - as supplied by publisher]