T ype 2 diabetic patients failing oral antidiabetes medications need insulin. If used appropriately and with patient cooperation, almost all patients can be well controlled. There is no agreed upon optimal mode of initiating insulin in this situation. In recent years, adding NPH insulin at bedtime (1–3) or 70/30 premixed insulin at suppertime (4) to the oral medications have been studied. Addin...

Abstract Objectives The study aim was to identify key factors associated with the health-related quality of life (HRQOL) patients type 1 diabetes mellitus (T1DM) treated neutral protamine Hagedorn (NPH) insulin or human analog glargine (IGLA). Methods We conducted two cross-sectional studies in Minas Gerais State, Brazil. One 401 IGLA, and other 179 T1DM NPH. HRQOL measured by Euroqol (EQ-5D-3L...

OBJECTIVE To describe the clinical experience and the pharmacokinetics of U-500 regular insulin in severely insulin-resistant obese type 2 diabetic patients. RESEARCH DESIGN AND METHODS Patients requiring >200 units of insulin with A1C levels >8.0% were switched to U-500 regular insulin. For the pharmacokinetic study, fasting subjects received 100 units of U-500 regular insulin subcutaneously...

In the natural history of type 2 diabetes, pancreatic insulin secretion is progressively depleted and metabolic control worsens. Treatment of these patients usually starts with diet and exercise, with subsequent use of oral glucose-lowering drugs, finally ending with insulin therapy to achieve good metabolic control. When there is still endogenous insulin secretion, the combination of insulin a...

OBJECTIVE We sought to compare and evaluate the impact of inhaled versus injected insulin on potential mediators of patient acceptance of insulin therapy while maintaining comparable A1C levels. RESEARCH DESIGN AND METHODS During a noninferiority efficacy trial conducted in 40 centers in the U.S., we surveyed treatment satisfaction, quality of life, and adherence barriers at weeks -4, -1, 6, ...

PRESENTATION R.J. is a 51-year-old man who has had type 2 diabetes for 18 years. Because of poor metabolic control with oral agents, he was prescribed a premixed formulation of regular and NPH insulin (Novo Nordisk, Madrid, Spain). Two weeks later, he developed pruritic lesions at the injection site. As treatment continued, lesions of similar characteristics developed in previous injection site...

In the natural history of type 2 diabetes, pancreatic insulin secretion is progressively depleted and metabolic control worsens. Treatment of these patients usually starts with diet and exercise, with subsequent use of oral glucose-lowering drugs, finally ending with insulin therapy to achieve good metabolic control. When there is still endogenous insulin secretion, the combination of insulin a...

OBJECTIVE The objective of this study was to evaluate the cost-effectiveness of insulin glargine compared with NPH insulin in patients with type 2 diabetes and in whom OAD (oral anti-diabetics) had failed in Switzerland. METHODS Long-term diabetes outcomes were simulated with the Diabetes Mellitus Model (DMM) over a period of 10 years. The incidences of long-term complications (micro- and mac...