Determining effective insulin analog therapy based on the individualized needs of patients with type 2 diabetes mellitus.

Abstract To manage patients with type 2 diabetes mellitus effectively and delay the onset of diabetes-related complications, therapeutic targets for glycemic control, as recommended by the American Diabetes Association and the American Association of Clinical Endocrinologists, should be implemented in clinical practice. Initiation of treatment with insulin is a critical step in achieving target glycemic levels. A variety of insulin formulations are available in the United States that can be matched to meet the diverse needs and lifestyles of patients with type 2 diabetes. In particular, insulin analogs have more predictable profiles of action and thus are able to more closely mimic physiologic insulin action. Case studies are presented to demonstrate the use of different types of insulin analogs in various situations as supported by data from clinical trials. The needs of the individual patient are considered in terms of his or her particular preferences, medical history, and adjustments for lifestyle concerns. The involvement of pharmacists in this individualized therapy is critical in order to enhance patients' understanding of their disease and their most effective treatment options.