Owing to the limited efficacy of monotherapy, the American Diabetes Association and the European Association for the Study of Diabetes recommend that combination therapy should be used when the glycated haemoglobin A1c (HbA1c) levels exceed treatment targets by 1.5% (≥8.5% for most patients), with insulin therapy needed if HbA1c exceeds 10% (evidence level E; expert consensus or clinical experience).7 Nevertheless, standardised treatment pathways for these patients remain unclear. Here, INS is linked to diabetes mellitus.