Insulin treatment in managing type 2 diabetes: challenges and opportunities.

Type 2 diabetes is a progressive disease in which diminishing pancreatic beta-cell failure can induce acute and chronic complications many years prior to diagnosis. Therefore, adhering to recommended standards of care and following a stepwise approach to the management of type 2 diabetes, with early initiation of insulin therapy that ameliorates both fasting and postprandial hyperglycemia, can address the progressive increase in insulin resistance and decline in insulin secretion. An insulin regimen that introduces basal and prandial doses of insulin gradually to sustain daytime glycemic control is both practical and effective.