Indications For Insulin Therapy In Type 2 Diabetes

Insulin therapy has multiple forms and applications in type 2 diabetes (Table 1). Some of these indications are temporary, such as during an acute illness, in pregnancy, and when those taking metformin are at risk for renal insufficiency or other factors predisposing to lactic acidosis. Insulin is also indicated as initial therapy when individuals present with severe hyperglycemia (fasting glucose over 300 mg dl or random glucose values over 400 mg dl) with significant symptoms such as severe...

Glucose Uptake by Insulin Independent Tissues

Some glucose transporter isoforms do not require insulin in order to be translocated to the cell membrane. For example, the glucose-2-transporter protein the predominant form in the liver and the endocrine pancreas remains in the cell membrane independent of insulin action. As a result, glucose is taken up passively down its concentration gradient into cells by these constantly available glucose transporter proteins. This allows the liver to take up glucose when the blood glucose concentration...