[Therapeutic options for a type 2 diabetic patient not well controlled with metformin plus basal insulin].

In a patient with type 2 diabetes not well controlled with a basal insulin - metformin combination, several therapeutic options may be considered: intensifying insulin therapy with different schemes (appropriate titration using a more favourable basal insulin analogue, adding one, two or three rapid-acting insulin analogues, shift to two or three premix insulin injections), adding a dipeptidyl peptidase-4 inhibitor (gliptin) or an inhibitor of sodium-glucose cotransporters type 2 (gliflozin), or combining a glucagon-like peptide-1 receptor agonist with basal insulin. The choice should be made according the individual profile and preference of the patient, in a personalized approach, taking into account the advantages and disadvantages of each therapeutic solution.
Competing Interests: A. Scheen déclare avoir reçu des honoraires comme orateur, membre d’un conseil scientifique ou investigateur clinicien de la part des firmes AstraZeneca, Boehringer Ingelheim, Janssen, Lilly, Merck Sharp & Dohme, Novartis, NovoNordisk, et Sanofi. Il a été investigateur clinicien dans les études EMPA-REG OUTCOME, CANVAS-R, TECOS et LEADER. N. Paquot a reçu des honoraires comme orateur de la part des firmes Merck Sharp & Dohme et NovoNordisk.