Choice of first injectable therapy in type 2 diabetes

A variety of injectable therapies are now available for use in patients of type 2 diabetes mellitus,when metformin alone proves inadequate. these injectable therapies include basal insulins,glucagon-like peptide 1 receptor agonists (glp1ra),co-formulations of basal insulin with glp1ra,and premixed or co-formulated dual action insulins. this article helps choose appropriate first injectable therapy in a rational manner,and achieve glycaemic control in an efficient way. the discussion utilizes the pharmacokinetic and pharmacodynamic properties of various injectable drugs to match them with various clinical situations. it highlights a gluco-phenotypic approach,utilizing readily available anthropometric measurements,glycaemic patterns,and other bio psychosocial parameters,to create a simple model which facilitates correct choice of first injectable therapy in type 2 diabetes. © 2016,pakistan medical association. all rights reserved.