INSULIN THERAPHY

1. Case discussion
Insulin therapy in a case of T2DM
uncontrolled on OADs

2. Mr. Sharma
• A person with T2DM uncontrolled
on multiple OADs

3. Age: 56 years old
Gender: Male
Weight: 70 kg Hip: 94cm
Body mass index: 23.9 kg/m2
Pulse: 74/min BP: 128/78 mmHg
Sr. Creatinine: 0.7 mg/dl
eGFR: 88 ml/min
Current medication:
 Metformin SR 850 mg BID
 Gliclazide XR 60 mg OD
 Linagliptin 5 mg OD
 Rosuvastatin 5 mg OD
 Telmisartan 80 mg OD
 Cilnidipine 20 mg OD
 Pregabalin 75 mg OD
 T2DM since 7 years
 Hypertension since 6 years
 Dyslipidemia since 6 years
 Symptoms of diabetic neuropathy since 1 year
Mr. Sharma
Teacher at a High School

4. March 2020
History of Mr. Sharma’s glycemic control
PPG: Post-dinner

5. Counselling was done for
insulin initiation and he
agreed
Introduce
OD IDegAsp + OADs
Mr. Sharma
Discontinued Gliclazide
Insulin initiation:

6. Case of insulin initiation: Mr. Sharma

7. Case of insulin initiation: Mr. Sharma

8. Case of insulin initiation: Mr. Sharma

9. Case of insulin initiation: Mr. Sharma

10. Case of insulin initiation: Mr. Sharma

11. Case of insulin initiation : Satish Chandekar
March 2021
Case of insulin initiation: Mr. Sharma
Adapted from case by Dr Om Lakhani

12. Mr. Sharma
March 2021
Current treatment:
• IDegAsp ( 00-00-24U)
• Metformin SR 850 mg BID
• Linagliptin 5 mg
• Rosuvastatin 10 mg
• Telmisartan 80 mg
• Cilnidipine 20 mg
• Pregabalin 75 mg OD
Learnings:
• Aim for TOTAL control to
address both the components
of dysglycaemia
• Insulin initiation should be
suited to individual
requirements considering
Indian realities of diabetes
management
Better control for FPG, PPG & HbA1c
after introduction of OD IDegAsp
At OD IDegAsp
initiation
Within 1 year of OD
IDegAsp
HbA1c: 9.5 % 6.9 %
FPG: 220 mg/dl 106 mg/dl
Post-breakfast: 246 mg/dl 124 mg/dl
Post-dinner: 312 mg/dl 152 mg/dl

13. Thank You