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: S. V. Yargin
Format: Article
Language:Russian
Published: Open Systems Publication 2021-07-01
Series:Лечащий Врач
Subjects:
Online Access:https://journal.lvrach.ru/jour/article/view/715
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author S. V. Yargin
author_facet S. V. Yargin
author_sort S. V. Yargin
collection DOAJ
description 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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spelling doaj-art-0abb2b4013654adb952df7c7f9d10f9e2025-08-20T03:20:17ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812021-07-01036910.51793/OS.2021.24.3.001714Early start of insulin therapy in type 2 diabetes mellitus: pros and consS. V. Yargin0Peoples' Friendship University of RussiaThe 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.https://journal.lvrach.ru/jour/article/view/715type 2 diabetes mellitusglycemic controlanti-diabetic drugsinsulin
spellingShingle S. V. Yargin
Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
Лечащий Врач
type 2 diabetes mellitus
glycemic control
anti-diabetic drugs
insulin
title Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
title_full Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
title_fullStr Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
title_full_unstemmed Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
title_short Early start of insulin therapy in type 2 diabetes mellitus: pros and cons
title_sort early start of insulin therapy in type 2 diabetes mellitus pros and cons
topic type 2 diabetes mellitus
glycemic control
anti-diabetic drugs
insulin
url https://journal.lvrach.ru/jour/article/view/715
work_keys_str_mv AT svyargin earlystartofinsulintherapyintype2diabetesmellitusprosandcons