Tuesday, February 22, 2011

insulin treatment in Type 2 diabetes - Part 2

Insulin Type

Manufactured insulin can be either synthetic (human) or animal in origin, and falls into five main categories

  • rapid-acting
  • short-acting
  • intermediate acting (also called isophane insulin)
  • fixed mixtures (of rapid - or short-acting and intermediate-acting insulin)
  • long-acting

Indications for insulin treatment

Strong indications for insulin therapy include:

  • symptoms of hyperglycaemia such as polyuria, thirst, 
    recurrent fungal infections (especially genital thrush) or bacterial infections (especially urine infections
  • pregnancy or planning pregnancy
  • oral hypoglycaemic treatments not tolerated/ contra-indicated
  • weight loss without dieting in someone of low or normal weight.
Possible indications for insulin therapy include:
  •  unsatisfactory glycaemic control, even with the maximum tolerated dose of oral hypoglycaemic agents (OHAs) (HbA1c higher than 7 per cent, self blood glucose monitoring results higher than 7 mmols/litre before meals or 9 mmols/litre two hours after meals) 
  • personal preference
  • painful neuropathy
  • foot ulceration and infection.


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