INS and diabetes mellitus: Type 2 diabetes (T2D) is characterized by a progressive decline in pancreatic beta-cell function and insulin secretion.1 As endogenous insulin secretion decreases, people with T2D require additional medications including insulin to maintain adequate glucose control, defined as hemoglobin A1c (HbA1c) < 7 by the American Diabetes Association.2 The progression of T2D is reflected in the treatment paradigm by which individuals progress through diet and exercise to one, two and frequently three anti-diabetic agents before beginning insulin therapy.