Optimum Insulin Therapy in Non-insulin-dependent Diabetes Mellitus *

However, it has also been recognized that the treatment of NIDDM patients frequently is inadequate even in those patients who should achieve the target range. In a recent population based cohort the median of glycosylated haemoglobin was 10.2% in NIDDM patients treated with diet or oral hypoglycemic agents (OHA) and 11.8% in NIDDM patients who used insulin. In a 5 year follow-up study of NIDDM patients the mean of baseline blood glucose averaged 11.2 mmol/l and it remained virtually unchanged at 5 yrs of diet or OHA treatment which did take place in community health centers. Similarly, overall experience from clinical practice is that the majority of NIDDM patients have persistently higher blood glucose levels and HBAlc levels than are acceptable or requested in the consensus recommendations. Consequently, it is evident that current therapeutic approaches are far from satisfactory to achieve and maintain normoglycemia in the majority of NIDDM patients and new approaches to treatment are needed.