Role of insulin in type 2 DM -
Insulin should be considered as the initial therapy in type 2 DM, paicularly in lean individuals or those with severe weight loss, in individuals with underlying renal or hepatic dis- ease that precludes oral glucose-lowering agents, or in individuals who are hospitalized or acutely ill. Insulin therapy is ultimately required by a substantial number of individuals with type 2 DM because of the progressive nature of the disorder and the relative insulin deficiency that develops in patients with long-standing diabetes. Reference : page 2415 Harrison&;s Principles of Internal Medicine 19th edition
Acute illness
Polyurea
Secondary OHA failure
Obese patient
Endocrinology