Insulin Therapy for Type 2 Diabetic Patients

Initial Insulin Therapy Approach

The American Diabetes Association recommends a starting dose of Humalog (insulin lispro) for type 2 diabetic patients of 4 units per meal, 0.1 units/kg per meal, or 10% of the basal insulin dose per meal if the patient is already on basal insulin 1, 2
Basal insulin is typically initiated in type 2 diabetes at 10 units per day or 0.1-0.2 units/kg/day, depending on the degree of hyperglycemia, as recommended by the American Diabetes Association 3, 4
When adding mealtime insulin, the starting dose can be 4 units per meal 5 or 0.1 units/kg per meal 2, and 10% of the basal insulin dose per meal 1, 2

The American Diabetes Association suggests adjusting Humalog doses based on self-monitoring of blood glucose results 3, 4
Educating patients on insulin self-management improves glycemic control, according to the American Diabetes Association 3
Dose titration should occur over days to weeks as needed, based on blood glucose patterns, as recommended by the American Diabetes Association 3
Self-titration algorithms based on SMBG can improve glycemic control in patients initiating insulin therapy, as found by the American College of Physicians 5, 2

Humalog is a rapid-acting insulin analog with a quick onset of action after dosing, as described by the American Diabetes Association 1
The American College of Physicians recommends administering Humalog just before meals due to its rapid onset of action 2
Comprehensive education regarding blood glucose monitoring, diet, and hypoglycemia management is critically important for patients using insulin, according to the American Diabetes Association 3, 5

When transitioning from other insulin regimens to Humalog, dose adjustments may be necessary, as recommended by the American Diabetes Association 4
The American Diabetes Association suggests continuing metformin therapy when initiating mealtime insulin like Humalog 6
Other oral agents may be discontinued on an individual basis to avoid complex regimens, as recommended by the American Diabetes Association 4
Sulfonylureas, DPP-4 inhibitors, and GLP-1 receptor agonists are typically discontinued when using complex insulin regimens beyond basal insulin, according to the American Diabetes Association 6

The American Diabetes Association recommends avoiding the use of insulin as a threat or describing it as a sign of personal failure or punishment 3, 5
Patient education on self-monitoring of blood glucose, diet, and hypoglycemia management is important, as emphasized by the American College of Physicians 3, 2
Cost considerations are important when selecting insulin products due to substantial price increases, as noted by the American Diabetes Association 1, 2
The progressive nature of type 2 diabetes should be regularly and objectively explained to patients, according to the American Diabetes Association 3, 4