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Is it right to use insulin as first line therapy in type 2 diabetes?

Responses (3)

williep 8 Jul 2017

My understanding is that although it isn't the usual first line therapy for type 2, insulin can help one to achieve tighter control. Today's short, thin needles make using insulin relatively painless. However, it does require greater vigilance to avoid lows. I have been using insulin only for the past five years, or so, but wish I had started it earlier; I was diagnosed back in 1991 and am experiencing some complications now

Nasouf 8 Jul 2017

Thanks for the answer, but as a pharmacist am looking for the best guideline for my patients.

CrazyAuntCyn 8 Jul 2017

When i was first diagnosed my bg was controlled only by diet & exercise & after a year or so metformin was added. It was around that time that i read an article that stated that newly diagnosed T2's should be started on a low dose of insulin to help preserve beta cells. My dr. didn't agree but after a few years & different oral meds i wound up on insulin. Looking back i wish i had been started much earlier, i believe i'd be better controlled now.

Nasouf 9 Jul 2017

Very helpful, but why do you think you should've had insulin earlier, although you don't say from the start!!!

amarsailles 18 Jul 2017

Insulin is not considered a first line drug for Type II diabetics even in cases of extremely high blood sugars. My A1C when diagonosed was 13 which is about as high as you get

The first line drug is Metformin and then a sulfonylurea like glipizide. They have the advantage of being cheap and pills so people will try them pretty easily. Diet and exercise are also powerful weapons. Only after this regimen is tried is insulin generally considered as well as drugs such as januvia, Farxiga and Victoza.

Each patient is different of course and the treatment needs to be focused on the individual For some patients for whom Metformin or glipizide are contraindicated or with extreme blood sugar levels, insulin may be needed as a first line treatment but generally speaking, the answer is no

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