Preferred insulin regimens in type 2 diabetes

Which insulin treatment regimen is preferred in patients with type 2 diabetes? What factors should be considered when selecting the regimen?

René Rodríguez-Gutiérrez, MD: That is a great question. In terms of efficacy, I would say all insulins are kind of the same. I think it is very important to take harms into consideration. Even though there is not a lot of difference in terms of the rate of hypoglycemia, that is something you want to look into.

The other thing is convenience, so how often the insulin has to be administered and how much it costs, which I think is a big thing right now because, as we know, the insulin cost is very high. Often the patient cannot afford one of the newer insulins but can use one of the old insulins, which are not bad.

The other thing that you have to take into consideration are the patient’s comorbidities. What other illnesses does the patient have? What is his or her family and social life context?

I think once you go through his or her illness or diabetes per se, other comorbidities, family issues, social issues, and values and preferences, then you can try to determine what is the best insulin for each patient. I think there is no single answer or an answer that all people go into the same box.