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Among all available glucose-lowering strategies, intensive (basal/bolus) insulin therapy has the greatest absolute potential for lowering A1C. The degree to which glycemia can be reduced with intensive insulin therapy is limited only by hypoglycemia. Unlike many other glucose-lowering medications that target either fasting plasma glucose or postprandial glucose, insulin can be used to target fasting glucose, postprandial glucose, or both, depending on the needs of the individual. Given the risks of hypoglycemia and weight gain, however, the risks and benefits of insulin treatment must be considered against those of other treatment approaches in people with T2D.

The following sections provide a general discussion of approaches to insulin use in people with T1D and T2D. While this information may be helpful in understanding generally recommended approaches to insulin use in these populations, the information provided is by no means the only approach to successfully initiating and titrating insulin in people with diabetes.

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