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Consider initial therapy at this stage when blood glucose 300 to 350 mg/dL (16.7 to 19.4 mmol/L) and/or HbA1C 10%-12% (86 to 108 mmol/mol), especially if the patient is symptomatic or if catabolic features (eg, weight loss, ketosis) are present, in which case basal insulin + mealtime insulin is the preferred initial regimen

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In cancer, circadian disruptiontriggered by irregular light exposure or shift workhas been linked to increased tumor risk and progression, partly due to dysregulation in clock-controlled ubiquitin-mediated degradation of oncogenes and tumor suppressors such as p53 (Reszka and Zienolddiny, 2018