Hermina Novida, - When to Start Basal Insulin Therapy in Type 2 Diabetes Patients. In: Surabaya Obesity Update, 8-9 Februari 2020, Surabaya.

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Abstract

Type 2 diabetes (T2D) accounts for 90% of all cases of diabetes, however, the vast majority of patients in treatment for T2D have suboptimal glycemic control, with glycated hemoglobin (AIC) levels greater than the 7%. The number of people living with diabetes mellitus in Indonesia has continued to increase over the last decade. Indonesia is ranked 7th in the world in terms of most people with diabetes. There were over 10,700,000 cases of diabetes in adults in Indonesia in 2019 (IDF Atias, 2019). Data at the Dr. Soetomo Hospital in 2007 showed that the prevalence of DM who underwent hospitalization reached 16.4% with a range of complications and mortality reached 28.8%. As the prevalence of DM is increasing, it is very important to improve glycemic control to delay microangiopathy, neuropathy and other complications of diabetes (Pranoto A et al. 2015). Traditional oral antidiabetic drugs (OADs) such as sulfonylureas (SUs). thiazolidinediones (TZDs), and metformin, have limited durability with respect to glycemic control. A 6-year survey determined that 53% of patients allocated to treatment with an SU required insulin therapy for the first time by the end of the study period. T2D is a progressive disease, characterized by gradual deterioration in pancreatic beta-cell function, decreasing insulin levels, and increasing insulin resistance, ultimately leading to chronic hyperglycemia. At diagnosis, most patients with T2D have already lost 50% of their remaining beta-cell function, which reduces rapidly over a period of just a few years. This rapid beta-cell decline means that insulin replacement quickly becomes necessary in order to achieve and maintain glycemic control, because other available therapies rely on the body's ability to produce insulin. As such, Insulin replacement is the most effective treatment for long-term control of hyperglycemia, and significant improvements in glycemic control can be achieved with this therapy in a short time.There are 3 stages to insulin therapy: initiation, optimization, and intensification. This review focuses on basal insulin initiation and optimization. The right time to initiate insulin therapy will be considered, as will suggestions for overcoming patient and physician barriers to initiating insulin therapy. Practical formula for patients Starting insulin therapy will be discussed, including the initial optimization of dose titration to achieve target Alc levels (Philis-Tsimikas, 2013).

Item Type:	Conference or Workshop Item (Paper)
Subjects:	R Medicine > RC Internal medicine
Creators:	Creators NIM Hermina Novida, - NIDN0012117705
Depositing User:	Miftachul Miftachul Mujayanah Mifta
Date Deposited:	13 Jun 2023 06:00
Last Modified:	14 Jun 2023 03:51
URI:	http://repository.unair.ac.id/id/eprint/127302
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