Which regimen is most commonly used to initiate insulin therapy in type 2 diabetes patients?

Initiating insulin therapy for patients with type 2 diabetes typically starts with a single injection of long-acting insulin. This approach is favored because it provides a baseline level of insulin that helps to manage fasting blood glucose levels throughout the day and night. Long-acting insulins, such as insulin glargine or insulin detemir, have a slow and steady release profile, which reduces the risk of hypoglycemia compared to more frequent dosing regimens.

This regimen allows for a more straightforward transition into insulin therapy, especially for patients who are not achieving glycemic control with oral medications. The simplicity of one injection can improve adherence and ease of use for patients who may be adjusting to the concept of insulin therapy.

In contrast, multiple daily injections of rapid-acting insulin might be appropriate for patients with more complicated control needs or those on a more intensive insulin regimen, but they may be overwhelming for someone just starting. A continuous insulin infusion, typically via an insulin pump, is usually reserved for patients needing more precise insulin delivery or for those who have not achieved control on multiple daily injections. Similarly, using short-acting insulin with every meal can lead to more fluctuations in blood glucose levels and requires careful meal timing and adjustment, making it less suitable as an