Fig. 4.

Initiation of insulin therapy with premix/insulin co-formulation. OAD oral antidiabetic agents, GLP-1 RA glucagon-like peptide-1 receptor agonist, OD once daily, BID twice daily, TID three times in a day. *OAD can be a sulfonylurea/thiazolidinedione/dipeptidyl peptidase-4 inhibitor or any other drug as per clinician’s judgment; **Start with OD 10–12 units (0.1–0.2 U/kg body weight). In the morning if the predinner blood glucose is high. In the evening if the prebreakfast blood glucose is high. Split the dose when dose is > 30 units. ***Intensification from OD to BID. Split the OD dose into equal breakfast and dinner doses (50:50). ****Intensification from BID to TID. Add 2–6 U or 10% of total daily premix dose before lunch. Down-titration of morning dose (− 2 to 4 U) may be needed after adding lunch dose. In both cases, continue metformin and administer premix just before meals

Modified from [54]