Insulin Therapy Strategies for Type 2 Diabetes Management
Summary
Insulin therapy remains a cornerstone in the management of type 2 diabetes, offering the most potent means to correct hyperglycaemia when lifestyle measures and oral agents prove insufficient. Strategies span from initiation of once-daily basal insulin to complex basal-bolus regimens, and include premixed or co-formulated preparations that combine basal and rapid-acting analogues in a single injection. Individualisation is guided by factors such as glycaemic targets, risk of hypoglycaemia, patient preference and comorbidities. Titration algorithms for basal insulin emphasise fasting plasma glucose measurements, whereas bolus insulins are adjusted to postprandial excursions. The advent of ultra-long-acting analogues and co-formulations seeks to simplify regimens and reduce glycaemic variability, while integrated delivery devices and digital platforms support real-time dose adjustments. Policymakers and clinicians must balance innovation with cost, accessibility and education to optimise global outcomes.
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Insulin Therapy Strategies for Type 2 Diabetes Management publication trend
The graph below shows the total number of articles in insulin therapy strategies for type 2 diabetes management across all publications each year (not limited to Nature Index journals).
Technical terms
Basal insulin: A long-acting formulation designed to provide steady background insulin levels between meals and overnight.
Bolus insulin: A rapid-acting preparation administered at mealtimes to control postprandial glucose excursions.
Co-formulation: A single injection combining basal and bolus insulin analogues in fixed ratio to simplify dosing.
Glycated haemoglobin (HbA1c): A measure of average blood glucose over the preceding two to three months, used to assess glycaemic control.
Glycaemic variability: Fluctuations in blood glucose levels over time, including undulations between hyperglycaemia and hypoglycaemia.
Hypoglycaemia: A state of abnormally low blood glucose, often defined as a plasma glucose concentration below 3.9 mmol/L, that can provoke neuroglycopenic symptoms.
References
- EADSG Guidelines: Insulin Therapy in Diabetes. Diabetes Therapy (2018).
- Efficacy and Safety of Once-Daily Insulin Degludec/Insulin Aspart versus Insulin Glargine (U100) for 52 Weeks in Insulin-Naïve Patients with Type 2 Diabetes: A Randomized Controlled Trial. PLOS ONE (2016).
- The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future. Frontiers in Public Health (2021).
- A Pragmatic Clinical Trial to Compare the Real-World Effectiveness of V-Go versus Standard Delivery of Insulin in Patients with Advanced Type 2 Diabetes. Journal of Health Economics and Outcomes Research (2019).
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