Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
The timely insulin administration can promptly normalize the blood glucose level. Indications for early insulin therapy include severe insulin deficiency often in young patients with low body weight; sarcopenia, cachexia and chronic infections especially in elder patients; early manifestation of mic...
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| Main Author: | |
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| Format: | Article |
| Language: | Russian |
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Open Systems Publication
2021-07-01
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| Series: | Лечащий Врач |
| Subjects: | |
| Online Access: | https://journal.lvrach.ru/jour/article/view/715 |
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| Summary: | The timely insulin administration can promptly normalize the blood glucose level. Indications for early insulin therapy include severe insulin deficiency often in young patients with low body weight; sarcopenia, cachexia and chronic infections especially in elder patients; early manifestation of microagiopathic complications, insufficient effectiveness of two- or three-component combinations of anti-diabetic drugs, severe symptoms associated with hyperglycemia. Adequate insulin therapy reduces lipo- and glucotoxicity, protects beta cells, other tissues and organs from damage. At the same time, there is an opinion that, in view of adverse effects of exogenous insulin and appearance of new anti-diabetic drugs, the insulin therapy should be started as late as possible. Adverse effects include the risk of hypoglycemia, weight gain and possibly also cardiovascular complications. Combinations of insulin with other hypoglycemic drugs and special features of insulin therapy in elder patients are discussed. There is a tendency for the target glycemic levels to increase with age. Obviously, the approach must be individual, taking into account age, clinical and laboratory data, comorbidities, preferences and possibilities of patients. |
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| ISSN: | 1560-5175 2687-1181 |