1.Concept Gao Hongjiao, Department of Endocrinology, Zunyi First People’s Hospital Basal insulin includes medium-acting human insulin and long-acting insulin analogues. The physiological secretion of insulin in normal human can be divided into basal insulin secretion and insulin secretion after meals, and the secretion of these two parts of insulin accounts for approximately the total insulin secretion of basal insulin, including medium-acting human insulin and long-acting insulin analogues. The physiological secretion of insulin in normal human can be divided into basal insulin secretion and post-meal insulin secretion, each of which accounts for about 50% of the total insulin. The so-called basal insulin secretion refers to the 24-hour continuous pulsed secretion of insulin by pancreatic islet cells (about 0.5 to 1 unit/hour), which means that basal insulin secretion does not depend on eating or refers to insulin secretion in fasting state, and the main physiological role of basal insulin is to reduce glucose production and maintain the use of glucose by surrounding tissues and organs (such as brain and muscles) by inhibiting hepatic glycogenolysis and gluconeogenesis. This is 50%. The so-called basal insulin secretion refers to the 24-hour pulsed secretion of insulin (about 0.5 to 1 unit/hour) by pancreatic islet cells, which means that basal insulin secretion is not dependent on food or insulin secretion in fasting state, and the main physiological role of basal insulin is to reduce glucose production and maintain the utilization of glucose by surrounding tissues and organs (such as brain, muscles, etc.) by inhibiting hepatic glycogenolysis and gluconeogenesis. Therefore, the main manifestation of insufficient basal insulin secretion in diabetic patients is elevated fasting blood glucose, but of course, insufficient or lack of plasma basal insulin also has an effect on postprandial blood glucose, and as fasting blood glucose rises, postprandial blood glucose also appears to “rise. The American Academy of Diabetes (ADA) and the European Society of Diabetes (EASD) guidelines recommend that after lifestyle intervention and oral hypoglycemic therapy, if glycemic control is still unsatisfactory, insulin therapy should be started as soon as possible, and the combination of basal insulin and oral hypoglycemic agents is preferred. China’s guidelines for the prevention and treatment of type 2 diabetes also recommend that in those whose blood glucose still does not reach the standard after lifestyle intervention and two oral drug combination therapy, insulin therapy (basal insulin once a day or premixed insulin once or twice a day) or a combination of three oral drugs can be added. 3. Advantages of basal insulin A good treatment plan should take into account three points: the effectiveness of the drug, safety, and patient compliance . When starting insulin, basal insulin is recommended because it is effective and convenient and can lower the overall blood glucose level, thus “lowering the boat”. The ideal basal insulin, such as long-acting insulin analogues (glargine insulin, detergent insulin), can mimic the physiological insulin secretion pattern and can meet the basal insulin demand for 24 hours with only one shot at any time of the day, and it does not produce significant peak values regardless of the dose, so the incidence of hypoglycemia is lower than other types of insulins. The above content is from the WeChat subscription number “Zunyi Diabetes Education Window”. You can join it by searching for the micro signal “zytnbw” in WeChat “Add Friend”, or you can directly “sweep” the above WeChat QR code to join.