Diabetes mellitus: insulin treatment methods and regimes

1. Big picture

Insulin treatment methods are built around one physiological idea:

Healthy pancreas = basal insulin all day + insulin bursts before meals. Therefore, insulin regimens try to replace:

1. Basal insulin → controls fasting and overnight glucose.
2. Prandial/bolus insulin → controls meal-related glucose rise.
3. Correction insulin → corrects unexpected hyperglycemia.

In type 1 diabetes mellitus (T1DM), insulin is mandatory because insulin secretion is absent or nearly absent. In type 2 diabetes mellitus (T2DM), insulin is added when endogenous insulin secretion is insufficient, when hyperglycemia is severe, or during acute stress states. Modern standards describe T1DM insulin therapy as individualized basal + prandial replacement, with many patients requiring approximately 0.4–1 unit/kg/day, of which around 30–50% is basal insulin. ([Diabetes Journals][1])

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