Background Many patients with type 2 diabetes need to progress to insulin use when oral glucose
lowering therapies fail to maintain adequate glycaemic control.
Objective To suggest when and how to initiate insulin therapy for patients with type 2 diabetes in
the primary care setting.
Discussion In general, initiation of insulin should be considered in individuals on maximal tolerated
doses of metformin and sulfonylureas with HbA1c levels >7.0% over a 3–6 month period.
Current Australian guidelines recommend initiating insulin therapy as once daily basal
therapy or as premixed insulins.
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