Newly diagnosed diabetes patients with significantly elevated blood sugar levels and pronounced hyperglycemic symptoms may need to start basal insulin therapy. The dose is usually calculated based on body weight, at 0.1-0.3 U/(kg·d). For obese patients or those with HbA1c > 8.0%, a starting dose of 0.2-0.3 U/(kg·d) may be considered.
If patients are using oral hypoglycemic agents but still have poor blood sugar control, insulin therapy may need to be initiated.
Type 1 diabetes patients, due to absolute insulin deficiency, should typically start insulin therapy immediately upon diagnosis.
Some type 2 diabetes patients may require insulin therapy due to unsuitability for oral hypoglycemic agents (e.g., those with liver or kidney dysfunction), failure of oral hypoglycemic agents, or advanced pancreatic function failure.
For gestational diabetes patients, who require stricter blood sugar control, insulin therapy should be initiated if diet therapy does not achieve satisfactory blood sugar control.