Insulin is used in the treatment of patients with diabetes of all types. The need for insulin depends upon the balance between insulin secretion and insulin resistance. All patients with type 1 diabetes need insulin treatment permanently, unless they receive an islet or whole organ pancreas transplant; many patients with type 2 diabetes will require insulin as their beta-cell function declines over time.
Indications for the use of insulin: Type 1 DM: due to autoimmune islet-cell injury that eventually leads to virtually complete insulin deficiency, type 1 DM is the first indication for the use of insulin. Ideally, physiologic replacement of insulin, imitating the secretory pattern of the nondiabetic pancreas is administered subcutaneously. Inhospital hyperglycemia management: Failure of OHA in type 2 DM GDM and/or Pregestational DM A more difficult question is when to use insulin in…
