{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T14:17:53Z","timestamp":1794493073267,"version":"4.9.1"},"reference-count":63,"publisher":"Bentham Science Publishers Ltd.","issue":"8","content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CDR"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n<jats:title>Abstract:<\/jats:title>\n<jats:p>The prevalence of type 2 diabetes mellitus has been increasing worldwide. As the therapeutic\noptions for type 2 diabetes mellitus have evolved over the last 2 decades, national and global\nguidelines related to type 2 diabetes mellitus pharmacotherapy issued by various organizations\nhave tended to vary in their recommendations. This narrative review aimed to analyze the key recommendations\nby major global and national guidelines on the initiation of insulin therapy in patients\nwith type 2 diabetes mellitus over the last 20 years. Strategies for insulin therapy for titration\nand intensification were also assessed. All guidelines recommend initiation of insulin (basal\/\npremixed\/other formulations) when glycemic targets are not achieved despite lifestyle measures\nand oral antidiabetic drugs. In the recent decade, early initiation of insulin has been recommended\nwhen the glycated hemoglobin levels are &gt;10% or blood glucose levels are \u2265300 mg\/dL (16.7\nmmol\/L). Initiation is recommended at a dose of 10 units or 0.1-0.2 U\/kg. Titration is advised to\nachieve the optimal dosage, while intensification is recommended when glycemic targets are not\nachieved despite titrating to an acceptable level. Glucose monitoring at periodic intervals is recommended\nfor adequate glycemic control. The guidelines further suggest that the choice of insulin\nshould be individualized, considering the clinical status of patients with type 2 diabetes mellitus.\nThe physicians as well as patients should be a part of the decisions made regarding the therapeutic\nchoice of regimen, preparation, and delivery device.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1573399819666230116150205","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T06:28:06Z","timestamp":1674109686000},"update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Evolution of Guideline Recommendations on Insulin Therapy in Type 2\nDiabetes Mellitus Over the Last Two Decades: A Narrative Review"],"prefix":"10.2174","volume":"19","author":[{"given":"Manoj","family":"Chadha","sequence":"first","affiliation":[{"name":"Department of Endocrinology, P.D. 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