The following diabetic patients need to use insulin
Type 1 diabetes: all use insulin, lifelong replacement
Second, gestational diabetes: all use insulin
Third, secondary diabetes mellitus need to use insulin
IV. Diabetes mellitus patients who are difficult to type
Type 2 diabetes mellitus has progressed to the stage where insulin is needed to control metabolism or to maintain survival or in the following cases
A Acute metabolic disorders (mostly short-term)
B Acute stress: perioperative period, perinatal period, severe infection, severe mental stress (short-term) C Those whose metabolism cannot be controlled normally after treatment with oral anti-diabetic drugs (OHA) (when HbA1C>7%)
D with severe ocular, renal, neurological, cardiovascular and skin complications
E Patients with wasting type 2 diabetes (insulin may be preferred)
F with chronic wasting diseases such as tuberculosis, cancer and liver cirrhosis
G Patients with severe hepatic and renal insufficiency
H Primary diagnosis of type 2 diabetes (short-term intensive: 2 weeks to 3 months)
(1) HbA1c greater than 9.0% with symptoms, should be intensified insulin therapy
(2) HbA1c greater than 9.0% with ketosis, must be treated with intensive insulin therapy
(3) HbA1c less than 9.0% or more than 9.0% without symptoms can be treated with intensive insulin therapy
I Type 2 diabetic patients with HbA1c greater than 7.0% after 3 months of treatment with oral anti-diabetic drugs can be treated with insulin
One oral anti-diabetic drug glycemic control does not meet the standard, can be used (can be preferred to basal insulin)
Two oral anti-diabetic drugs do not meet the standard of blood glucose control, should be used (basal or premixed insulin)
Three oral anti-diabetic drugs do not meet the standard of blood sugar control, must be used (premixed or basal insulin)
In conclusion, there is no absolute contraindication to the use of insulin in diabetic patients, but it must be activated in time and early use is recommended when it should be used, so as to favor the stable control of blood sugar and the prevention of complications.