Typically we as medical professionals usually postpone our starting of insulin in type 2 patients as long as possible. This has become easier over the past few years as we have had four new classes of medications come into the market in the last seven years. Each of these classes attack hyperglycemia by different methods, giving us a large armada of weapons.
However, since we now see the onset of diabetes occur at a younger age, the odds that any of these medications will reduce the number of patients who will go on insulin in their lifetime is slim to none.
This increased use of insulin now and into the future, puts extra pressure on us as insulin dose adjustment is often very time consuming and requires more frequent interaction with the patients. Our feature this month looks at patient self-titrating of insulin and how that compares with prescriber- or educator-based titration.