Place of insulin therapy in current approaches to the treatment of type 2 diabetes

Type 2 diabetes mellitus (T2DM) is a high risk factor for the development of macrovascular complications. Several large studies have demonstrated the fundamental role of early extensive blood glucose control in the prevention of these complications. An aggressive approach in achieving normoglycemia in patients with T2DM and existing macrovascular complications could lead to an increase in cardiovascular outcomes, which has a clear association with hypoglycemic conditions. Insulin therapy (IT) remains one of the most effective pharmacological treatments for diabetes provided adequate and timely prescription. The advent of long-acting insulin analogues helped not only to reduce the incidence of hypoglycemia as one of the most clinically relevant adverse events of IT, but also marked certain prospects in the prevention of type 2 diabetes in people with prediabetes.