The use of insulin should be individualized, i.e., an individualized treatment plan should be adopted for each patient according to his/her disease type, condition, age, weight, fatness, liver and renal function status, work and rest routine, and economic conditions. There are two common treatment programs:

(1) Insulin plus oral hypoglycemic agents

Subcutaneous injection of intermediate and long-acting insulin at bedtime to control basal blood glucose (fasting and preprandial) and oral hypoglycemic agents before three meals to control postprandial blood glucose. It is suitable for those who still have partial islet function but have elevated fasting blood glucose.

 

It is usually started at a small dose and the starting amount is determined by the level of glycosylated hemoglobin and body weight.

 

(2) Insulin replacement therapy programs

Mimics physiologic insulin secretion and relies on insulin to control blood glucose throughout the day. There are three commonly used regimens:

 

① Pre-mixed insulin injection before breakfast and dinner. For patients with high postprandial blood glucose or high blood glucose throughout the day. For patients who have regular meals, between 10 and 12 hours between morning and evening meals, and rarely add meals in between.

 

② Inject short-acting (or fast-acting) insulin before three meals. Suitable for patients with simple postprandial hyperglycemia.

 

③Short-acting (or fast-acting) insulin is injected before three meals and intermediate-acting (or long-acting) insulin is injected before bedtime. It is suitable for patients with both high fasting and postprandial blood glucose or patients with large fluctuations in blood glucose, postprandial hyperglycemia and preprandial and nocturnal hypoglycemia.

Alternative treatment regimens are primarily indicated for diabetic patients with complete islet failure, such as those with T1DM, as well as those with advanced severe T2DM.

 

The information is from the Internet and is for reference only.