Insulin therapy is a personalized approach to glycemic management in diabetes

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Abstract

Type 2 diabetes is characterized by chronic hyperglycemia and varying degrees of insulin resistance and insulinopenia. Achieving targeted glycemic control in diabetic patients is important to reduce the risk of late complications, and many patients with type 2 diabetes ultimately require insulin therapy to maintain adequate glycemic control. Timely administration of insulin can prevent the progression of diabetes, reduce the development of complications, and have fewer side effects. Basal insulin is the preferred option in most cases when glycemic control is not achieved. However, there is considerable therapeutic inertia in clinical practice, both with respect to initiation of insulin therapy and titration of the basal insulin dose. The longer duration of action, reduced glucose variability and a lower risk of hypoglycemia seen with the latest generation of basal insulin analogs compared to the previous generation simplify titration and may increase patient compliance.

About the authors

T. Yu. Demidova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: t.y.demidova@gmail.com
ORCID iD: 0000-0001-6385-540X

д.м.н., проф., зав. каф.

Russian Federation, Moscow

V. V. Titova

Pirogov Russian National Research Medical University

Email: t.y.demidova@gmail.com
ORCID iD: 0000-0002-8684-6095

ассистент

Russian Federation, Moscow

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Supplementary files

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2. Figure: 1. Continuous monitoring of patient M.'s glycemia during the initiation of basic-bolus insulin therapy.

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3. Figure: 2. Continuous monitoring of patient M.'s glycemia against the background of titration of insulin doses.

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4. Figure: 3. Continuous monitoring of patient K.'s glycemia during treatment with PSSP.

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5. Figure: 4. Continuous monitoring of patient K.'s glycemia when initiating basal insulin therapy.

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6. Figure: 5. Continuous monitoring of patient K.'s glycemia against the background of titration of the basal insulin dose.

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7. Figure: 6. Patient-driven basal insulin dose titration algorithm (M. Davies, 2005).

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