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It is well established that tight glycaemic control in type 2 diabetes (T2DM) reduces the risk of microvascular complications. The majority of patients will, at some point, need to start insulin therapy in order to achieve the American Diabetes Association (ADA) goal of a glycated haemoglobin (HbA1c) below 7%. This is largely because of the progressive loss of betacell function associated with the course of T2DM. Adding insulin to oral agent therapy can be an effective means of reaching the target level for HbA1c. This approach has proved to be feasible in clinical trials that rely on dose-titration protocols for regular adjustment of the insulin dose. Furthermore, reliable patients should be able to follow such protocols and make dose changes based on their home glucose-monitoring values. The timely addition of insulin to an oral agent regimen along with close attention to its optimal dosing will lead to better glucose control, which will translate into better health for these patients.

Insulin Initiation in Patients not Adequately Controlled on Oral Agents