Naslov
Initiation of insulin therapy: How to start with basal insulin?

Autori
Baretić, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, pp prezentacija, stručni

Izvornik
ADIT 2016, 8th International Conference on Advances in Diabetes and Insulin Therapy / - , 2016

Skup
ADIT 2016, 8th International Conference on Advances in Diabetes and Insulin Therapy

Mjesto i datum
Dubrovnik, Hrvatska, 21.04.2016. - 23.04.2016

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
diabetes type 2; basal insulin; therapy

Sažetak
Majority of patients starting basal insulin therapy have failed their oral antidiabetic regimen. Basal insulin is used sometimes also as a first line therapy in patients with newly diagnosed type 2 diabetes, with symptomatic and/or elevated blood glucose levels and/or high HbA1c. Usual scheme is oral antidiabetic therapy during the day and intermediate or long-acting insulin at bedtime. Basal insulin treats fasting hyperglycemia that correlates with hepatic glucose production, which can be suppressed by bedtime insulin. The initial dose of basal insulin dosing can be based on average FBG (fasting plasma glucose), body weight (0.1–0.2 units/kg) or it can be clinically estimated. FBG should be measured every day with a periodical increase of 2-4 units if the FBG is above targeted range. When the patient has more pronounced insulin resistance, initial dose of insulin is higher and titration more aggressive. The bedtime insulin dose can be titrated over a prolonged time by the patient itself. Most of people with type 2 diabetes requiring basal insulin should be already using metformin unless contraindicated or not tolerated. After initiation of evening insulin, patients should be kept on their oral antidiabetic agents, having in mind that insulin secretagogues when used in combination with insulin increase risk of hypoglycemia. Once FBG is in the target range pre- lunch, pre-dinner and bedtime glucose values should be checked and oral anti-diabetic agents adjusted (or changed). Prandial insulin should be considered when basal insulin has been titrated to targeted FBG level, but HbA1c is still above target.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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