WHEN SHOULD A DIABETIC PATIENT START INSULIN THERAPY?
• Glucose Sensor Implants • Return to Health Insulin injections have been relegated to a therapy of last resort in patients with Type II diabetes. This was not always true. In the 1970s, insulin was regularly used to reduce blood glucose levels, sometimes by as much as 30-40 mg/dL. According to a report in JAMA, better glucose control resulted in fewer cardiovascular events occurring among insulin-dependent patients, but (unfortunately) insulin failed to impact the overall death rate (Knatterud et al. 1978). According to Zachery Bloomgarden, M.D., insulin resulted in a 10-year mean HbA1c level of 7.1% compared with 7.9% in a group not treated with insulin. Hypoglycemia, however, occurred in 37% of patients on insulin, exceeding the 11% who experienced hypoglycemia on chlorpropamide (a first-generation sulfonylurea) and the 18% on glyburide (a second-generation sulfonylurea). Mean weight gain was 6.5 kg over 10 years among insulin users compared to 4.2 kg on chlorpropamide and 5.1 kg on
