Diabetes

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One of the most enduring lessons from my training in the care of geriatric patients is the following maxim: “Treat every new symptom like a (possible) drug adverse effect until proven otherwise.”

Patients with type 2 diabetes eventually need insulin therapy as their disease progresses. The American Diabetes Association recommends basal-only therapy initially, with the addition of bolus meal-time insulin as needed. However, recent research supports starting patients on combined basal-bolus regimens to control blood sugar regardless of added hypoglycemia risk.