Insulin Therapy Management in Type 2 Diabetes
Summary
Insulin therapy is a cornerstone of management in type 2 diabetes when oral agents and lifestyle interventions no longer achieve glycaemic targets. The progressive decline in pancreatic β-cell function coupled with insulin resistance necessitates exogenous insulin. Clinical regimens range from basal analogues, which address fasting glycaemia, to basal–bolus strategies that mimic physiological insulin secretion. Modern long-acting and ultrarapid-acting formulations offer improved pharmacokinetic profiles, reducing hypoglycaemia risk and affording greater flexibility. Individualised titration protocols guided by self-monitoring of blood glucose or continuous glucose monitoring enable safe dose adjustments. Comprehensive patient education and psychosocial support are essential to overcome barriers such as needle aversion, weight gain concerns and treatment burden. Innovations in digital health, including telemedicine and connected insulin delivery systems, are reshaping self-management and enhancing adherence. International guidelines underscore the importance of timely initiation and intensification to mitigate microvascular and macrovascular complications, advocating a patient-centred approach that balances stringent glycaemic control with quality of life.
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Insulin Therapy Management in Type 2 Diabetes publication trend
The graph below shows the total number of articles in insulin therapy management in type 2 diabetes across all publications each year (not limited to Nature Index journals).
Technical terms
Basal insulin: Long-acting insulin analogue administered once or twice daily to control fasting blood glucose.
Bolus insulin: Short-acting or ultrarapid-acting insulin given at mealtimes to manage postprandial glucose excursions.
Insulin titration: The process of adjusting insulin doses based on glucose measurements to achieve target glycaemic levels.
Psychological insulin resistance: Patient reluctance or refusal to initiate or intensify insulin therapy due to beliefs, fears or misconceptions.
Self-monitoring of blood glucose (SMBG): Regular capillary blood glucose testing by patients to inform treatment decisions and dose adjustments.
References
- Factors associated with psychological insulin resistance among patients with type 2 diabetes in China. Frontiers in Endocrinology (2024).
- Applying the theory of planned behavior to investigate type 2 diabetes patients' intention to receive injection therapy. Frontiers in Public Health (2023).
- A practical approach to the clinical challenges in initiation of basal insulin therapy in people with type 2 diabetes. Diabetes/Metabolism Research and Reviews (2020).
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