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A practical approach and algorithm for intensifying beyond basal insulin in type 2 diabetes.

Ronald M Goldenberg1, Peter Assimakopoulos2, Jeremy D Gilbert3

  • 1LMC Diabetes and Endocrinology, Thornhill, Ontario, Canada.

Diabetes, Obesity & Metabolism
|May 1, 2018
PubMed
Summary

Intensifying type 2 diabetes treatment beyond basal insulin is challenging but crucial. This review offers evidence and an algorithm to improve glucose control and achieve treatment targets.

Keywords:
basal insulinglucose-lowering agentsintensification strategies

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacotherapy

Background:

  • Type 2 diabetes management often requires treatment intensification.
  • Suboptimal intensification beyond basal insulin is a global challenge.
  • Evidence supports aggressive antihyperglycaemic regimens.

Purpose of the Study:

  • To review options for advancing glucose-lowering therapy beyond basal insulin.
  • To provide a practical algorithm for optimizing patient care.
  • To enhance achievement of glycaemic targets.

Main Methods:

  • Comprehensive literature review of antihyperglycaemic intensification strategies.
  • Synthesis of evidence on treatment options beyond basal insulin.
  • Development of a clinical algorithm for treatment advancement.

Main Results:

  • Multiple evidence-based options exist for intensification beyond basal insulin.
  • Current practices often fall short of recommended intensification.
  • An optimized algorithm can guide clinical decision-making.

Conclusions:

  • Timely and aggressive intensification of antihyperglycaemic therapy is essential for type 2 diabetes.
  • A structured approach and algorithm can improve patient outcomes.
  • Addressing suboptimal intensification is key to achieving glycaemic control.