When initiating insulin for type 2 diabetes, the primary justification should be to prevent acute hyperglycemia, not as a long-term management strategy without addressing the underlying disease.

“when we take someone with type 2 diabetes whose glucose is out of control to the point where we need to put them on insulin the mandatory discussion that needs to occur is i'm going to put this medicate i'm going to give this medication this insulin that you're going to inject to you okay and i'm going to do that because your blood sugars are so high that they could acutely kill you okay put you into the hospital put you at risk of all these”