Early and aggressive initiation of insulin therapy for type 2 diabetes: what is the evidence?

Abstract

Type 2 diabetes is a progressive disease in which beta-cell function continually declines and eventually fails, ultimately requiring nearly all patients to be placed on insulin therapy. An increasing body of evidence suggests that early intensive glycemic ontrol reduces long-term vascular outcomes and potentially may prolong beta-cell lifespan and function. Herein, evidence in favor of early insulin therapy on disease progression and long-term outcomes will be reviewed and placed into clinical context.