Basal Insulin Concept: Howto Treat the Target in T2DM Patients with Basal Insulin

• Main Author: Sony Wibisono
• Format: Book Section PeerReviewed
• Language: English; English
• Published: Pusat Diabetes dan Nutrisi RSUD Dr. Soetomo, Surabaya 2018
• Subjects: R Medicine (General); RC Internal medicine
• Online Access: http://repository.unair.ac.id/108687/1/C-33.pdf; http://repository.unair.ac.id/108687/2/C-33%20kadep.pdf; http://repository.unair.ac.id/108687/
• Institution: Universitas Airlangga

Worldwide, bith underdiagnosis and undertreatment leave many patients exposed to long periods of hyperglycemia and contribute to irreversible diabetes complications. Early glucose control reduces the risk of both macrovascular and microvascular complications, while tight control late in diabetes has little or no macrovascular benefit. Insulin therapy offers the most potent antihyperglycemic effect of all diabetes agents, and has a unique ability to induce diabetes remission when use to normalize glycemia in newly diagnosed patients. When used as a second-line therapy, basal insulin is more likely to safely and durably maintain A1C levels d+ 7% than when insulin treatment is delayed. The use of basal insulin analogs is associated with a reduced risk of hypoglycemia and weight gain compared to NPH insulin and premixed insulin. Patient self-titration algorithms can improve glucose control while decreasing the burden on office staff.