Recommend starting insulin immediately if the HbA1c is > 10% (90mmol/mol) at any time, as these patients typically will not reach their glycaemic targets despite lifestyle management and all other glucose-lowering therapies.

Formal Recommendations

Recommendation & Evidence

Recommendation StrengthNone

Evidence LevelNone

无

People with type 2 diabetes and HbA1c >10%

Start insulin immediately

Lifestyle management and non-insulin glucose-lowering therapies alone

Achievement of glycemic targets in severe hyperglycemia

Evidence No.-

Evidence-

Evidence LevelNone

Recommendation StrengthNone

Statement TypeFormal Recommendations

Guideline NameSamoa MOH National Diabetes Guidelines

Guideline No.2-2024-035E

AuthorAlec Ekeroma

Guideline TypeGuideline

Year2024

OrganizationMinistry of Health Samoa

RegionOceania

CountrySamoa

Conflict of InterestNo

DOI无

Target Population所有糖尿病患者（包括1型糖尿病、2型糖尿病、妊娠期糖尿病、儿童及青少年），特别是萨摩亚及太平洋人群，包括高危人群（超重/肥胖、有家族史、既往糖尿病史等）

Journal无

Recommendation Strength Methodology无

Evidence Level Methodology无

Living GuidelineNo

Rapid AdviceNo

UpdatedNo

Recommendation Count0

Reference Count50

Guideline TopicComprehensive

CategoriesTreatment initiation, intensification, and adjustment, Insulin therapy

Created At2026-07-28 17:47:18

Updated At2026-07-28 17:47:18