scholarly journals Effectiveness and tolerability of treatment intensification to basal–bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study

2015 ◽  
pp. 569 ◽  
Author(s):  
Martin Pfohl ◽  
Thorsten Siegmund ◽  
Stefan Pscherer ◽  
Katrin Pegelow ◽  
Jochen Seufert
Keyword(s):  
Type 2 Diabetes ◽  
Observational Study ◽  
Insulin Glargine ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Oral Therapy ◽  
Treatment Intensification ◽  
Insulin Glulisine

Switching to Insulin Glargine 300 U/mL (Gla-300) Improves Glycemic Control and Reduces Nocturnal Hypoglycemia in Patients (Pts) with Type 2 Diabetes (T2DM) on Basal Insulin Supported Oral Therapy (BOT)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1020-P ◽  
Author(s):  
JOCHEN SEUFERT ◽  
ANDREAS FRITSCHE ◽  
HELMUT ANDERTEN ◽  
KATRIN PEGELOW ◽  
STEFAN PSCHERER ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Oral Therapy ◽  
Nocturnal Hypoglycemia

scholarly journals Glucagon-like peptide-1 receptor agonists, selection within the class. The rational combination of insulin glargine 100 + lixisenatide

2020 ◽  
pp. 50-55
Author(s):  
M. V. Martjanova ◽  
A. Yu. Babenko
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Cell Function ◽  
Significant Proportion ◽  
Cardiovascular Complications ◽  
Effective Dosage ◽  
Receptor Agonists

Type 2 diabetes mellitus (T2DM) is a progressive disease accompanied by a gradual worsening of β-cell function. With a long course of T2DM, a significant proportion of patients develop absolute insulinopenia and there is a need to transfer the patient from oral hypoglycemic drugs (OHD) to basal insulin therapy in combination with OHD or to the basal-bolus regimen of insulin therapy (IT). More than 80% of patients with T2DM are obese or overweight and the addition of insulin, which is a lipogenetic hormone, to the therapy contributes to even greater weight gain, which serves as a prerequisite for increasing cardiovascular risks, as well as the appearance and progression of biomechanical problems such as arthrosis of the joints, venous insufficiency. In this review article, we will consider and evaluate the benefits of administering combinations of basal insulin glargine in combination with glucagonlike peptide-1 receptor agonists (GLP-1ra) lixisenatide to one of the most rational treatment regimens for patients with T2DM insulin deficiency and persistent insulin resistance. Also, the article focuses on the variability of glycemia, which according to research can play an important role in the pathogenesis of atherosclerosis and can be an independent risk factor for cardiovascular complications in patients with diabetes. Due to the fact that glycemic control is based on the determination of predominantly glycated hemoglobin (HbA1c) as a measure of average glucose concentration, it is known that this marker does not accurately reflect glycemic variability, which is characterized by the amplitude, frequency and duration of hypo- and hyperglycemic fluctuations. A fixed combination of insulin preparations glargin 100 and GLP-1ra lixisenatide allows to select individually effective dosage for a patient with type 2 diabetes and obesity, will help to achieve several goals at the same time - from improving glycemic parameters without increasing body weight and without increasing the risk of hypoglycemia, to significantly reduce the need for insulin with its previous use, as well as reduce the risk of cardiovascular complications.

Clinical Predictors of the Need for Further Treatment Escalation in Patients with Type 2 Diabetes on Basal Insulin Therapy – A Retrospective Observational Study

2019 ◽  
Vol 127 (10) ◽  
pp. 663-671
Author(s):  
Christina Buchholz ◽  
Melanie Kahle-Stephan ◽  
Juris J. Meier ◽  
Michael A. Nauck
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Plasma Glucose ◽  
Basal Insulin ◽  
Target Range ◽  
Diabetic Patients ◽  
Treatment Intensification ◽  
Oral Agents ◽  
Glucose Profiles

Abstract Background/Aims The aim of this study was to identify clinical characteristics that distinguish patients who achieve sufficient glycaemic control with basal insulin and oral glucose-lowering medications from those who need treatment intensification. Patients/Methods 213 out of 1 042 consecutively hospitalized type 2-diabetic patients were treated with basal insulin/oral agents. After titration to fasting glucose target, in 156 patients (73.2%) continuation of basal insulin treatment was recommended, while in 57 (26.8%), intensification of treatment was necessary. We compared patients’ characteristics and plasma glucose profiles between these groups. Results Patients needing intensified regimens (basal-bolus regimes, premixed insulin ;GLP-1 receptor agonists) had higher initial HbA1c values (87±17 mmol/mol [10.1±1.7%] vs. 80±19 mmol/mol [9.5±1.9%], p=0.028), were more likely to be female (49.1 vs. 25.0%, p=0.0014) and more obese, and required higher basal insulin doses (62±40 vs. 39±27 IU/d, p<0.0001). In both patient groups, basal insulin reduced fasting plasma glucose into the target range (6.6±1.3 vs. 5.7±0.8 mmol/l), however, in those needing treatment intensification, post-breakfast plasma glucose remained substantially higher after basal insulin titration (12.6±2.0 vs.9.4±1.6 mmol/l, p<0.0001). Before hospital discharge, similar plasma glucose profiles were reached in both groups. Conclusions Basal insulin therapy can provide satisfactory glucose control in more than 70% of patients with type 2 diabetes. Long diabetes duration, obesity, insulin resistance and female sex indicate a need for further treatment intensification.

scholarly journals Prandial Options to Advance Basal Insulin Glargine Therapy: Testing Lixisenatide Plus Basal Insulin Versus Insulin Glulisine Either as Basal-Plus or Basal-Bolus in Type 2 Diabetes: The GetGoal Duo-2 Trial

Diabetes Care ◽  
2016 ◽  
Vol 39 (8) ◽  
pp. 1318-1328 ◽  
Author(s):  
Julio Rosenstock ◽  
Bruno Guerci ◽  
Markolf Hanefeld ◽  
Sandro Gentile ◽  
Ronnie Aronson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Insulin Glulisine ◽  
Basal Bolus
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