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The Diabetes Educator, Vol. 32, No. 3, 423-432 (2006)
DOI: 10.1177/0145721706288255
© 2006 American Association of Diabetes Educators; Published by SAGE Publications

FEATURES

Physiologic Insulin Replacement in Type 2 Diabetes

Optimizing Postprandial Glucose Control

Carolyn Robertson, APRN, MSN CDE, BC-ADM

From Diabetes Team Associates, New York, New York.

Correspondence: Carolyn Robertson, Diabetes Team Associates, 345 East 37th Street, Suite 313, New York, NY 10016 (carolyn.robertson{at}nydiabetesteam.com).

Purpose

The purpose of this article is to review physiologic insulin replacement using a basal-prandial approach and focus on the role of postprandial glucose control. In addition, therapeutic options for optimizing glycemic control are described, including diabetes education, currently available agents, treatment regimens, and strategies.

Methods

This article reviews the benefits of treating with a basal-prandial insulin approach and focuses on post-prandial glucose-targeted therapies, including rapid-acting insulin analogs.

Results

Data from landmark clinical trials in type 2 diabetes suggest that intensive glycemic control can reduce the frequency and severity of diabetes complications. A basal-prandial insulin regimen combines a long-acting insulin analog with a rapid-acting insulin to mimic normal physiologic insulin secretion, providing a flexible tool to enhance patient self-management.

Conclusions

Strategies that include patient education, improved health care provider/patient communication, and basal-prandialinsulin treatment can help patients achieve good glycemic control. The optimal setting for successful diabetes treatment is a team approach with the health care provider, nurse/certified diabetes educator, and patient as essential members.


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This article has been cited by other articles:


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Flexible Intensive Versus Conventional Insulin Therapy in Insulin-Naive Adults With Type 2 Diabetes: An open-label, randomized, controlled, crossover clinical trial of metabolic control and patient preference
Diabetes Care, December 1, 2007; 30(12): 3031 - 3032.
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