Type 2 Diabetes Management
Managing Type 2 Diabetes
- Management of type 2 diabetes includes self-care education and support, achievement of glycemic targets, and minimization of cardiovascular and other long-term risk factors.1
- The 2021 American Diabetes Association Standards of Medical Care in Diabetes recommend achieving an HbA1c goal for many nonpregnant adults of 70% with Time below Range <4%.2
- To achieve these HbA1c and TIR goals, many people with type 2 diabetes require insulin.3
3 Ways Insulin is Provided to People with T2D:
Basal insulin therapy with intermediate- or long-acting preparations.
On average, 1 or 2 injections per day*
On average, 2 or 3 injections per day*
Basal – bolus regimen or ‘intensive insulin therapy’. A basal-bolus regimen (or "intensive insulin therapy") may be achieved by MDI of insulin or by CSII delivered by an insulin pump).
MDI: on average 4.5 injections per day**.
Pump/CSII: One cannula insertion for up to
The ADA recommends considering insulin pump therapy as an option for adults and youth with type 2 diabetes and other forms of diabetes who are on multiple daily injections.4
Benefits of Insulin Pump vs MDI in T2D Patients
In addition to the above, insulin pumps provide more physiological method of insulin delivery and more favorite pharmacokinetics and pharmacodynamics than the basal insulin regimen.1
Cons of CSII therapy compared to MDI in patients with T2D: costs; requires teaching and education program; requires some technological abilities or assistance to operate, not suitable for moderate and severe cognitive impairment, technical problems (like blockage of infusion set), local skin infections.1
Facts about Type 2 Diabetes in the US:
- 88 million American adults — approximately 1 in 3—have prediabetes.5
- 34.2 million Americans—just over 1 in 10— have diabetes.5
- Approximately 7.4 million Americans with diabetes use insulin.6
*Depending on the type of long acting insulin.
**14 injections/3 days based on people with T1D on MDI taking ≥ 3 bolus and 1-2 basal injections/day multiplied by 3 days. Chiang et al. Type 1 Diabetes Through the Life Span: A Position
Statement of the American Diabetes Association. Diabetes Care. 2014:37:2034-2054
1. Landau Z, et al. Diabetes Metab Res Rev. 2017; 33 e 2822.
2. American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S73-S84.
3. American Diabetes Association 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021 Jan; 44 (Supplement 1): S111-S124.
4. American Diabetes Association. 7. Diabetes technology: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44(Suppl 1):S85-S99.
5. Centers for Disease Control and Prevention. Accessed April 11, 2021. https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html.
6. Cefalu WT, et al. Diabetes Care. 2018;41(6):1299-1311.