scholarly journals Efficacy and Safety of IDegLira Versus Basal-Bolus Insulin Therapy in Patients With Type 2 Diabetes Uncontrolled on Metformin and Basal Insulin: The DUAL VII Randomized Clinical Trial

Diabetes Care ◽  
2018 ◽  
Vol 41 (5) ◽  
pp. 1009-1016 ◽  
Author(s):  
Liana K. Billings ◽  
Ankur Doshi ◽  
Didier Gouet ◽  
Alejandra Oviedo ◽  
Helena W. Rodbard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Insulin Therapy ◽  
Randomized Clinical Trial ◽  
Basal Insulin ◽  
Efficacy And Safety ◽  
Bolus Insulin ◽  
Basal Bolus

scholarly journals Management of Type 2 Diabetes – Methods for Addition of Prandial to Basal Insulin

2014 ◽  
Vol 10 (2) ◽  
pp. 124 ◽  
Author(s):  
Helena W Rodbard ◽  
Boris Karolicki ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Multiple Dose ◽  
Treatment Guidelines ◽  
Clinical Inertia ◽  
Dose Titration ◽  
Bolus Insulin ◽  
Basal Bolus

As glycaemic control deteriorates with the progression of type 2 diabetes, treatment guidelines advocate starting basal insulin therapy, and then progressing to a basal–bolus regimen as needed. Nevertheless, although timely intensification of therapy is important to minimise the risk of diabetic complications, considerable clinical inertia exists, not only in the initiation of insulin but also in the progression to multiple-dose insulin regimens. One barrier has been the lack of guidance about how to make the transition from basal-only to basal–bolus insulin therapy. In this review, we discuss how data from the recent FullSTEP study, along with other randomised studies, will help to bridge this gap. Prandial boluses can be added to basal insulin in a stepwise manner, using a straightforward, patient-led dose titration approach and simple estimation of which meal to add the initial prandial bolus to. Reducing the complexity of progression to multiple-dose insulin regimens and empowering patients will lessen the burden on clinicians, improve treatment satisfaction and facilitate timely implementation of treatment guidelines.

scholarly journals Management of Type 2 Diabetes – Methods for Addition of Prandial to Basal Insulin

2014 ◽  
Vol 10 (02) ◽  
pp. 132
Author(s):  
Helena W Rodbard ◽  
Boris Karolicki ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Multiple Dose ◽  
Treatment Guidelines ◽  
Clinical Inertia ◽  
Dose Titration ◽  
Bolus Insulin ◽  
Basal Bolus

As glycaemic control deteriorates with the progression of type 2 diabetes, treatment guidelines advocate starting basal insulin therapy, and then progressing to a basal–bolus regimen as needed. Nevertheless, although timely intensification of therapy is important to minimise the risk of diabetic complications, considerable clinical inertia exists, not only in the initiation of insulin but also in the progression to multiple-dose insulin regimens. One barrier has been the lack of guidance about how to make the transition from basal-only to basal–bolus insulin therapy. In this review, we discuss how data from the recent FullSTEP study, along with other randomised studies, will help to bridge this gap. Prandial boluses can be added to basal insulin in a stepwise manner, using a straightforward, patient-led dose titration approach and simple estimation of which meal to add the initial prandial bolus to. Reducing the complexity of progression to multiple-dose insulin regimens and empowering patients will lessen the burden on clinicians, improve treatment satisfaction and facilitate timely implementation of treatment guidelines.

Insulin Dosage Adjustments After Initiation of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes

2021 ◽  
pp. 089719002199362
Author(s):  
Mandy Chen ◽  
Etty Vider ◽  
Roda Plakogiannis
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Retrospective Chart Review ◽  
Insulin Dosage ◽  
History Of ◽  
Bolus Insulin

Background: Combination of insulin and GLP-1RAs have shown reductions in the HbA1c, body weight, and the risk of hypoglycemia. To date, there are conflicting data regarding the effect of GLP-1RAs on insulin dosage(s). Objective: The objective of this study was to evaluate adjustments of insulin doses upon initiation of GLP-1RAs. Methods: This was a retrospective chart review of patients on insulin therapy initiated on GLP-1RAs at NYU Langone Health. Patients were included in the study if they were at least 18 years of age, history of type 2 diabetes, and were on concurrent basal or mixed insulin therapy. 45 patients met inclusion criteria and were included in the study analysis. The primary endpoint was the median change in overall basal insulin doses. Secondary endpoints included median changes in total basal, mixed, and bolus insulin doses, oral antidiabetic medications and GLP-1RA doses, HbA1c, body weight, fasting glucose, and creatinine clearance. Safety results included any adverse reactions to insulin and/or GLP-1RA. Results: In the per-protocol analysis, there was a significant reduction in overall total basal insulin doses from baseline to week 24 (50 units vs. 44 units, p < 0.05). There was a median reduction in patients receiving glargine (50 units vs. 44 units) and detemir (29 units vs. 21.5 units). Conclusions: Use of GLP-1RAs after 24 weeks resulted in a statistically significant reduction in overall total basal insulin dosages from baseline. The median HbA1C in our patient population was >8%. Consider a ≥10% reduction in the overall basal insulin dose upon initiation of GLP-1RA in patients with a HbA1C >8%.

Switching to basal-bolus insulin therapy is effective and safe in long-term type 2 diabetes patients inadequately controlled with other insulin regimens

2013 ◽  
Vol 60 (5) ◽  
pp. 249-253
Author(s):  
Irene Vinagre ◽  
Juan Sánchez-Hernández ◽  
José Luis Sánchez-Quesada ◽  
Miguel Ángel María ◽  
Alberto de Leiva ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Bolus Insulin ◽  
Basal Bolus ◽  
Term Type ◽  
Diabetes Patients
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