Consensus on "Basal insulin in the management of Type 2 Diabetes: Which, When and How?".

Introduction: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment. Appropriate initiation and intensification of insulin is critical for the successful achievement of tight glycaemic control.

Insulin glargine versus insulin degludec in patients failing on oral therapy in type 2 diabetes: A retrospective real world comparative data from India.

Objective: To compare the changes in various glycemic parameters in insulin-naïve type 2 diabetes mellitus (DM) patients who were initiated on insulin glargine or insulin degludec in a real world setting.

Methods: Retrospective data were analyzed in consecutive type 2 DM patients in a real world setting, who failed oral therapy (at least 2 oral anti-diabetic drugs) and were initiated with either insulin glargine or insulin degludec. The parameters assessed were the changes in HbA1c, fasting plasma glucose, body weight, dose of Insulin and the total number of patient reported hypoglycemic episodes up to 6 months after initiation.

Is insulin degludec a more effective treatment for patients using high doses of insulin glargine but not attaining euglycemia? Some case reports from India.

Insulin therapy is not without side effects. In patients with complications on complex regimens, failure to attain adequate glycemic control exposes the patient to high risks and the considerable mental distress associated with failed injectable therapy. As clinicians, we felt it necessary to undertake a trial of newer therapies like insulin degludec, which according to published literature, appears to be superior to earlier basal analogs by fewer hypoglycemic episodes, better glycemic predictability, and genuine 24-hour coverage.