In many patients with inadequately controlled type 2 diabetes, insulin is added to the treatment regimen. This often includes a daily dose of a long-acting insulin, as well as rapid-acting or short-acting insulin, sometimes with a sliding scale, to control elevated glucose following meals. Thus, treatment with insulin can impose a major burden, requiring patients to check blood glucose and inject insulin multiple times per day and to appropriately adjust insulin doses. The use of rapid-acting or short-acting insulin can also increase the risk for hypoglycemia, which is of particular concern in the elderly. In a research letter published in this issue of JAMA Internal Medicine,1 Munshi et al provide preliminary data to suggest that, compared with multiple doses of insulin, a single dose of basal insulin results in less hypoglycemia with little effect on glycated hemoglobin.
Grady D. Simplification of Insulin Regimens in Patients With Type 2 Diabetes. JAMA Intern Med. 2016;176(7):1025. doi:10.1001/jamainternmed.2016.2298