Insulin in practice for people with type 2 diabetes mellitus

摘要

The use of insulin in type 1 diabetes mellitus (/article/ld/diagnosis-and-management-of-type-1-diabetes-mellitus) is life-saving owing to the absolute insulin deficiency resulting from autoimmune destruction of the beta cells in the pancreas [1] . Type 2 diabetes mellitus (T2DM) is characterised as a progressive disease owing to a combination of the development of insulin resistance and continuing decline of beta cell function [2] . Although glycaemic control is usually achieved by other glucose-lowering therapies — such as metformin, sulfonylureas, pioglitazone, dipeptidyl peptidase 4 (DPP4) inhibitors, sodium-glucose cotransporter 2 (SGLT2) inhibitors (/article/feature/updated-nice-guidance-for-type-2-diabetes-what-do-you-need-to-know) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) (/article/ld/glucagon-like-peptide-analogues-in-adults-with-type-2-diabetes-mellitus-for-glycaemic-control) — some people with T2DM may need insulin to achieve optimal glycaemic control [3] .