VOL 72 No 2 March 2023
DOI: 10.12788/jfp.0532

Evolution and Revolution—Our Changing Relationship With Insulin

Type 2 diabetes is a progressive condition with a complex pathophysiology. Over time, additional therapies are needed to maintain glycemic control. It is well known that, by the time of diagnosis, beta cell function has already declined by 50% to 80%. When the body is no longer able to make enough insulin to control blood glucose levels, insulin replacement therapy is needed. However, barriers to initiation of insulin therapy are multifactorial and contribute to delays in treatment and consequent uncontrolled glycemia; this leads to an increased risk of disease complications. In this roundtable discussion, the authors review how people living with type 2 diabetes and their healthcare providers view the initiation of insulin. Other topics include the benefits of longer-acting basal insulin analogs compared with long-acting analogs. The authors emphasize the importance of early and positive conversations about insulin therapy, as well as the benefits of shared decision-making and the use of the wider medical team for the timely initiation of basal insulin therapy.

Video 1: Introduction

Video 1: Introduction

Video 2: Insulin Therapy Has Evolved Dramatically, But Have Our Perceptions?

Video 3: Preparing for Insulin Therapy Success in Type 2 Diabetes Starts at Diagnosis—What Should We Be Talking About?

Video 4: Assessing Patient Readiness for Insulin Therapy

Video 5: Effective Initiation and Titration of Basal Insulin Therapy

Video 6: Ensuring Long-Term Success With Basal Insulin Therapy


About the Panel

John Anderson, MD Photo

John Anderson, MD

is an internal medicine specialist practicing at the Frist Clinic in Nashville, TN.

Mary Van Doorn Photo

Mary Van Doorn, Diabetes Paraprofessional, Level 1, AADE; Personal Trainer, SCW; Specialist Certified, Diabetes Motion Academy

is a type 2 diabetes advocate, diabetes paraprofessional, certified personal trainer, and the founder of Sugar Mama Strong Diabetes Support for Women, a support group for women with diabetes.

Jodi Strong, DNP, CDCES, BC-ADM, CPT Photo

Jodi Strong, DNP, CDCES, BC-ADM, CPT

is a diabetologist who manages the Diabetes Services Department at Aspirus Medical Group, a multispecialty clinic in Stevens Point, WI.


This peer-reviewed publication was developed in adherence with Good Publication Practice (GPP3) guidelines. All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship and have disclosed all potential conflicts of interest.

John Anderson, MD
Has received consulting fees or speaker honoraria from Abbott, Alfa Sigma, Bayer, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Gelesis, Novo Nordisk, and Sanofi

Mary Van Doorn, Diabetes Paraprofessional, Level 1, AADE; Personal Trainer, SCW; Specialist Certified, Diabetes Motion Academy
No disclosures

Jodi Strong, DNP, CDCES, BC-ADM, CPT
Has served on speakers bureau for Abbott, Boehringer Ingelheim, Merck, Novo Nordisk, and Sanofi; and has attended advisory board meetings for Novo Nordisk, and Sanofi


This digital publication was funded by Sanofi US. The authors received writing and editorial support from Helen Jones, PhD, of Evidence Scientific Solutions. This support was funded by Sanofi US.