Table 2: Protocol for possible withdrawal of insulin treatment.
| 1. | It is imperative to agree with the patient lifestyle changes |
| 2. | Metformin increasing doses, up to the maximum tolerated dose |
| 3. | Remove your insulin regimen |
| 4. | Start long acting insulin, 0.5u/kg at bed time |
| 5. | If the requirement was < 0.2 u/Kg, we can stop insulin immediately. |
| 6. | Consider arGLP1 or isGLT2 |
| 7. | Self-monitoring blood glucose each day in the morning, fasting |
| 8. | If three consecutive controls > 150 mg/dl: + 2u. (long acting insulin dose) |
| 9. | If three consecutive controls < 120 mg/dl: - 2u. (long acting insulin dose) |
| 10. | If daily requirement < 0.2u / kg, maintain metformin and remove insulin. |
| 11. | Nutrition educator control every week, for the first month |
| 12. | BMI > 35 and inadequate HbA1c, value consider arGLP- 1 / isGLT2 ) |
| 13. | Subsequently, routine monitoring follow |