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Fine-tuning therapy with basal insulin for optimal glycemic control in type 2 diabetes: a review.
Curr Med Res Opin. 2004 Dec; 20(12):2007-14.CM

Abstract

OBJECTIVE

To review results from clinical studies utilizing basal insulin therapy and discuss the impact of intensive glycemic control using forced-titration algorithms to fine-tune insulin dosing in patients with type 2 diabetes mellitus.

RESEARCH DESIGN AND METHODS

A Medline and PubMed search was undertaken for the years 1991-2004 using the following search terms: insulin, diabetes therapy, forced titration, glycemic control, and intensive insulin therapy.

RESULTS

The United Kingdom Prospective Diabetes Study demonstrated that the great majority of patients with type 2 diabetes will eventually require insulin and have provided level IA evidence that intensive glycemic control improves patient outcomes. Several recently published studies in patients with type 2 diabetes showed that forced titration of basal insulin shows promise in reaching glycemic goals. Forced-titration algorithms employ a structured approach in helping patients achieve glycemic targets: doses are adjusted until glycemic goals (predefined glycosylated hemoglobin concentrations and/or blood glucose levels) are met.

CONCLUSION

Studies have indicated that forced-titration regimens using insulin analogs to attain aggressive glycemic targets have the potential to improve outcomes in patients with type 2 diabetes without compromising patient safety. These forced-titration algorithms are straightforward and designed to be adaptable to individual needs, which may help overcome barriers to insulinization of patients with type 2 diabetes.

Authors+Show Affiliations

Division of Diabetes and Endocrinology, Scripps Clinic, La Jolla, California 92037, USA. gdailey@scrippsclinic.com

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15701217

Citation

Dailey, George. "Fine-tuning Therapy With Basal Insulin for Optimal Glycemic Control in Type 2 Diabetes: a Review." Current Medical Research and Opinion, vol. 20, no. 12, 2004, pp. 2007-14.
Dailey G. Fine-tuning therapy with basal insulin for optimal glycemic control in type 2 diabetes: a review. Curr Med Res Opin. 2004;20(12):2007-14.
Dailey, G. (2004). Fine-tuning therapy with basal insulin for optimal glycemic control in type 2 diabetes: a review. Current Medical Research and Opinion, 20(12), 2007-14.
Dailey G. Fine-tuning Therapy With Basal Insulin for Optimal Glycemic Control in Type 2 Diabetes: a Review. Curr Med Res Opin. 2004;20(12):2007-14. PubMed PMID: 15701217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fine-tuning therapy with basal insulin for optimal glycemic control in type 2 diabetes: a review. A1 - Dailey,George, PY - 2005/2/11/pubmed PY - 2005/4/20/medline PY - 2005/2/11/entrez SP - 2007 EP - 14 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 12 N2 - OBJECTIVE: To review results from clinical studies utilizing basal insulin therapy and discuss the impact of intensive glycemic control using forced-titration algorithms to fine-tune insulin dosing in patients with type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS: A Medline and PubMed search was undertaken for the years 1991-2004 using the following search terms: insulin, diabetes therapy, forced titration, glycemic control, and intensive insulin therapy. RESULTS: The United Kingdom Prospective Diabetes Study demonstrated that the great majority of patients with type 2 diabetes will eventually require insulin and have provided level IA evidence that intensive glycemic control improves patient outcomes. Several recently published studies in patients with type 2 diabetes showed that forced titration of basal insulin shows promise in reaching glycemic goals. Forced-titration algorithms employ a structured approach in helping patients achieve glycemic targets: doses are adjusted until glycemic goals (predefined glycosylated hemoglobin concentrations and/or blood glucose levels) are met. CONCLUSION: Studies have indicated that forced-titration regimens using insulin analogs to attain aggressive glycemic targets have the potential to improve outcomes in patients with type 2 diabetes without compromising patient safety. These forced-titration algorithms are straightforward and designed to be adaptable to individual needs, which may help overcome barriers to insulinization of patients with type 2 diabetes. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/15701217/Fine_tuning_therapy_with_basal_insulin_for_optimal_glycemic_control_in_type_2_diabetes:_a_review_ L2 - https://www.tandfonline.com/doi/full/10.1185/174234304X15183 DB - PRIME DP - Unbound Medicine ER -