Insulin Therapy Indications

insulin therapy indications guys of

course all the type 1 diabetes mellitus

patients will need insulin therapy keep

in mind that these patients are usually

lean and young you know that majority of

the type 1 diabetes mellitus patients

will be identified or diagnosed before

puberty other patients are usually

diagnosed by the 30th year of age or

before the 30th year of age so these

patients will have to go on insulin type

2 diabetes mellitus patients it is a

little bit more tricky to figure out

when to start them on insulin many times

patient and doctor both are fearful to

start on the insulin therapy because of

the fear of the pin pricks and glucose

tests and so on also sometimes patients

actually take this as their failure and

they are hesitant to start saying hey

why not I try to improve my diet or

exercise and so on just reassure them

that type 2 diabetes mellitus is insulin

resistance plus the beta cells start

burning out and sometimes you you reach

a point where there is sufficient

quantity of the beta cells lost that

they the remaining cells just cannot

make enough insulin to meet the body's

needs so they will have to go on the

insulin therapy normally 10 to 15 years

after the onset of type 2 diabetes

mellitus the patients will need to go on

the insulin however this is a general

criteria that you as a practitioner as a

doctor should know and that is that when

one of the drugs the first light drug is

metformin when that drug fails you have

a choice to make to either start another

oral drug or to start with the insulin

normally we start in another oral drug

or even a third oral drug however if

hemoglobin a1c levels are greater than

8.5% then consider starting on in saline

instead of another oral agent so here

are some of the

guidelines to start thinking about

insulin therapy when hemoglobin a1c

levels are greater than nine point five

percent that is for sure start on

insulin if you do a fasting glucose

level for a patient and the levels are

greater than 250 milligrams per

deciliter start on insulin or consider

starting on every random glucose if that

is greater than 300 milligram per

deciliter start on in saline ketonuria

is present unplanned weight loss is

present in association with

hyperglycemia or if the patient is

actually not known to be of type 1 or

type 2 diabetes mellitus but the patient

has come to you with hyperglycemia or

with ketosis so such patients will need

to start on insulin as well guys thank

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