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Type 2 diabetes:
insulin treatment is no cause for alarm

Insulin treatment to prevent hyperglycaemia and its related complications may be necessary in some uncontrolled type 2 diabetes patients. Patients are more likely to accept and continue the treatment if it is not made to sound alarming and they are well informed.

Type 2 diabetes develops naturally towards an increase in hyperglycaemia. When hyperglycaemia can no longer be controlled by oral hypoglycaemic treatment alone, i.e. when the glycosylated haemoglobin (HbA1C) is over 8%, adding an insulin injection at bed-time should be considered.

Initiating insulin treatment requires simple explanations and instructions, but the patient does not need to go into hospital. The treatment, which combines a bed-time insulin injection with an oral antidiabetic treatment, is not very painful and is only moderately restrictive for the patient who is able to administer the injections him/herself. Hypoglycaemic-type complications are rarely serious. They can be prevented when the patient is aware of the circumstances when such complications are likely to occur, is familiar with their symptoms, and knows how to prevent and correct them.

The initial low dose of insulin is subsequently adjusted through self-monitoring of blood sugar levels on an empty stomach in the morning. The use of an injection pen makes the insulin injection process easier and more straightforward.

The addition of insulin is neither a symptom of the seriousness of the condition, nor necessarily permanent. After having tried it, more than 85% of patients agree to carry on with insulin treatment.

©Prescrire June 2005

Source: "L'insuline dans le diabète de type 2 deuxième partie. Modalités pratiques du traitement par insuline dans le diabète de type 2 : des principes simples pour passer des données à la pratique " Rev Prescrire 2005 ; 25 (262) : 443-449.

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