Clinical Outcomes and Complications of Basal, Bolus, and Combination Insulin Regimens in Type 2 Diabetes Mellitus: Evidence from Published Case Reports
Abstract
Insulin therapy remains a cornerstone in the management of type 2 diabetes mellitus (T2DM), especially in patients experiencing progressive loss of pancreatic beta-cell function or those with inadequate glycemic control despite oral antidiabetic therapy. This review synthesized clinical outcomes from 44 peer-reviewed case reports published between 2019 and 2024, identified through systematic searches in PubMed and Scopus. The included cases involved 15 males and 29 females, with patient ages ranging from 11 to 91 years (mean 53 ± 20.85 years). Subcutaneous insulin was the most frequently used route of administration, while intravenous insulin was reserved for managing acute complications. The most commonly reported complication was diabetic ketoacidosis (DKA), especially in patients with delayed insulin initiation or in those receiving sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of oral glucose-lowering agents, one of whose side effects is known to elevate the risk of euglycemic DKA. Other triggers included COVID-19 infection and severe insulin resistance. Most patients received basal insulin regimens, whereas basal-bolus combinations were preferred in more complex or unstable cases. Insulin was frequently combined with oral agents, such as metformin, dipeptidyl peptidase IV (DPP-IV) inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, or sodium-glucose cotransporter 2 (SGLT2) inhibitors, reflecting a trend toward individualized treatment strategies.…
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.