Don't Jump to Insulin Even if Glucose is Very High in New-Onset Type 2 Diabetes

We're getting questions about how to treat patients with newly diagnosed type 2 diabetes and VERY high blood glucose.

A random glucose of 20 mmol/L or an A1C of 12% in these patients can sound alarming...and guidelines suggest starting insulin right away if the patient is symptomatic with metabolic changes such as ketosis.

But using insulin to rapidly lower blood glucose isn't always needed. Plus it may not be practical...due to a steep learning curve, patient resistance, concerns about hypoglycemia or cost, etc.

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