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Ward A, Tardiff S, Dye C, Arrighi HM
Until recently, the recommended strategy for intensifying insulin therapy was the addition of rapid-acting insulins (RAIs) to the treatment regimen, either as additional prandial injection or as part of a premixed insulin formula
A recalibrate program can be even more effective with medications like Mounjaro or Ozempic
Side Effects & Safety Nausea most common (~33% at high doses), dose-dependent, typically improves over time GI effects vomiting, diarrhea, constipation, slowed gastric emptying (GLP-1 class effects) Heart rate changes transient increases observed in trials, peaked at 24 weeks then declined Injection site reactions mild redness or irritation Gallbladder risk rapid weight loss increases gallstone risk (common with any rapid weight loss method) No major safety signals in 48-week trial up to 12 mg weekly At community doses (1.5 mg/week), side effects are notably milder than high-dose trial groups Dosage Chart This dosage chart consolidates the doses reported in published Phase 2 trials and self-reported community protocols, expressed in milligrams (mg) and converted to units on a standard 100-unit / 1mL insulin syringe
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