concept · created 2026-08-26 · updated 2026-08-26 · treatment, insulin
For severe insulin dependence (C‑peptide <0.2 nmol/L), the protocol recommends basal‑bolus regimens (e.g., long‑acting + twice short‑acting + correction), lifestyle base measures (fasting caution, exercise, sleep, stress, glucose monitoring, diet), metformin (especially in women), pioglitazone for lean, acarbose for overweight, GLP‑1RA, SGLT2 inhibitors (with cautions), and DPP‑4 inhibitors as second line. Insulin reduction strategies focus on tapering short‑acting insulin and preserving basal doses. See fasting-precautions-diabetes and sleep-hygiene-diabetes.
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