Patients with Type II Diabetes with Insulin Resistance should not immediately be prescribed insulin as the pancreas is working harder to produce insulin naturally but the insulin that is already present is not being properly utilized by the body. Instead, a diet and pharmaceutical regimen that focuses on the underlying causes of insulin resistance is preferable as an intervention method to prevent the necessity of insulin therapy. DeFronzo (2009) recommends a combination metformin, a thiazolidinedione, and exenatide to increase the patient’s insulin sensitivity and aid in the body’s ability to properly utilize the existing insulin.
Notably, both DeFronzo (2009) and DeWitt and Hirsch (2003) recognize that Type II Diabetes is a progressive disease and that the pancreas, after overly producing insulin to promote natural absorption, will eventually decline in its production if the insulin sensitivity has not been increased. In these scenarios, the body does not produce enough insulin and the body does not properly use insulin that is provided through pharmaceutical regimens. The necessity of the combination treatments discussed by DeFronzo (2009) then remains but the addition of insulin therapy must also be added to this combination. The progression of the diabetes and condition of the pancreas should be monitored closely to make this distinction.
- DeWitt, D.E., & Hirsch, I.B. (2003). Outpatient insulin therapy in type 1 and type 2 diabetes
mellitus. Journal of American Medical Association. 289(17), pp 2254-2264.
- DeFronzo, R.A. (2009). From the triumvirate to the ominous octet: A new paradigm for the
treatment of type 2 diabetes mellitus. Diabetes. 58(4), pp 773 – 795.