[DAROC Symposium 5] Medication
22 Mar 2026
14:00
15:30
102
Insulin Therapy Across the Spectrum of Diabetes
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|---|---|
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14:00
14:30
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102
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14:30
15:00
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Ju-Ying JiangTaiwan
Speaker
When, What, and How: Practical Approaches to Insulin Use in Type 2 DiabetesPractical insulin use in type 2 diabetes (T2D) requires clear decisions on when to start therapy, what regimen to choose, and how to titrate effectively. Insulin is indicated when lifestyle measures and non-insulin medications fail to achieve glycemic goals, especially when Hba1c is ≥10%, fasting glucose is >250–300 mg/dL, or when patients show symptomatic hyperglycemia or catabolic features. Insulin is also required during acute illness, surgery, pregnancy, or corticosteroid use.
Basal insulin remains the preferred first step due to its simplicity and lower hypoglycemia risk. Long-acting insulin analogues such as Glargine or Degludec are commonly initiated at 10 units or 0.1–0.2 U/kg/day with stepwise titration. When additional blood sugar control is needed, options include adding a GLP-1 receptor agonist, moving to basal-plus or basal-bolus regimens, or using premixed insulin for patients with fixed routines.
Importantly, once-weekly basal insulin formulations—such as insulin icodec—are emerging as a future option, offering flatter pharmacokinetics and the potential to improve adherence by reducing injection frequency. These agents may simplify initiation and long-term management for patients hesitant about daily injections.
Overall, individualized regimen selection, structured titration, and patient-centered education remain essential for safe and effective insulin therapy.
102
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15:00
15:30
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Jia-Hong LinTaiwan
Speaker
The New Era of Insulin Therapy: Ultra-Long Acting, Smart Delivery, and BeyondInsulin therapy is entering a transformative era driven by innovations in pharmacology, delivery systems, and data integration, fundamentally reshaping diabetes management. The development of ultra-long-acting basal insulin analogues has markedly improved glycemic stability by providing flatter, more predictable pharmacokinetic and pharmacodynamic profiles with extended duration of action. These agents reduce glycemic variability, lower the risk of nocturnal and overall hypoglycemia, and allow greater dosing flexibility, thereby improving treatment adherence and quality of life for people with diabetes.
Beyond molecular advances, smart insulin delivery technologies are redefining how insulin is administered and titrated. Continuous subcutaneous insulin infusion (CSII) systems integrated with continuous glucose monitoring (CGM) have evolved into automated insulin delivery (AID) or hybrid closed-loop systems that dynamically adjust basal insulin and deliver correction boluses based on real-time glucose data. These systems consistently demonstrate superior time-in-range, reduced hypoglycemia, and decreased patient burden compared with conventional multiple daily injections or sensor-augmented pump therapy. Increasingly, algorithm refinement, interoperability, and personalization are enabling broader clinical applicability across age groups and diabetes phenotypes.
Collectively, these advances signal a paradigm shift from reactive glucose control toward proactive, personalized, and technology-enabled insulin therapy. The integration of ultra-long-acting insulins, smart delivery systems, and digital innovations promises to further improve glycemic outcomes, safety, and patient-centered care in the management of diabetes.
102
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