Diabetes & Primary Care’s series of interactive case studies is aimed at all healthcare professionals in primary and community care who would like to broaden their understanding of diabetes.
These two scenarios cover situations when insulin therapy might be appropriate in a person with type 2 diabetes, and the practicalities of initiation.
The format uses typical clinical scenarios as tools for learning. Information is provided in short sections, with most ending in a question to answer before moving on to the next section.
Working through the case studies will improve our knowledge and problem-solving skills in diabetes care by encouraging us to make evidence-based decisions in the context of individual cases.
Readers are invited to respond to the questions by typing in their answers. In this way, we are actively involved in the learning process, which is hopefully a much more effective way to learn.
By actively engaging with these case histories, readers will feel more confident and empowered to manage such presentations effectively in the future.
Janet, 65 years old, has had type 2 diabetes for 14 years. She has background retinopathy but is otherwise without serious medical problems. Her HbA1c is 68 mmol/mol (8.4%) despite maximum tolerated doses of metformin, dapagliflozin and subcutaneous semaglutide.
How would you seek to manage Janet’s hyperglycaemia?
Raj is 59 years old, of South Asian ethnicity, and has had type 2 diabetes for 11 years. He has diabetic nephropathy, retinopathy and cardiovascular disease. A year after starting basal insulin therapy, his HbA1c has improved but remains at 68 mmol/mol (8.4%).
What would be your next step in optimising Raj’s glucose levels?
By working through this interactive case study, we will review when insulin therapy might be appropriate in a person with type 2 diabetes, and the practicalities of initiation.
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25 May 2026