FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Published at www.nejm.org October 22, 2009 (10.1056/NEJMe0908706)

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Patients with type 2 diabetes have peripheral insulin resistance and inadequate insulin secretion by pancreatic beta cells. During meals, reduced first-phase insulin secretion results in postprandial hyperglycemia and in a 35% decrease in hepatic glycogen storage.¹ A 55% increase in nocturnal hepatic gluconeogenesis drives excessive glucose production and fasting hyperglycemia.¹ Ultimately, in 90% of patients with progressive beta-cell insufficiency, lifestyle changes and oral drug therapy are insufficient, and patients require exogenous insulin supplementation to achieve a glycated hemoglobin level below the recommended 7% target.^2,3

The aim of insulin supplementation is glycemic control and a reduction in microvascular disease and, if . . . [Full Text of this Article]

Source Information

From the Institute for Clinical Diabetology, German Diabetes Center, and the Department of Metabolic Diseases, Heinrich Heine University Clinics — both in Düsseldorf, Germany.

This article (10.1056/NEJMe0908706) was published on October 22, 2009, at NEJM.org.

This article has been cited by other articles:

• (2009). Comparison of Three Insulin Regimens. JWatch General 2009: 1-1 [Full Text]