Consider initiation of insulin regardless of background glucose lowering tx or dz stage if there s evidence of ongoing catabolism e g unexpected wt loss if sx of hyperglycemia are present or when A1C or blood glucose levels are very high i e A1C 10 or blo

Consider initiation of insulin regardless of background glucose-lowering tx or dz stage if there’s evidence of ongoing catabolism (e.g., unexpected wt loss), if sx of hyperglycemia are present, or when A1C or blood glucose levels are very high (i.e., A1C >10% or blood glucose ≥300 mg/dL). [E]