Mr A is a 89 year old patient with type 2 diabetes, congestive heart failure, end-stage kidney disease, and anaemia. His diabetes regimen consists of four insulin injections daily. He cannot take oral medications because of his kidney and heart diseases. His glucose concentrations range between 70 mg/dL and 150 mg/dL before breakfast, and between 80 mg/dL and 160 mg/dL before meals and at bedtime. His HbA1C result—although not reliable because of his anaemia—is 7·1% (54 mmol/mol).