scholarly journals Guidelines for Premeal Insulin Dose Reduction for Postprandial Exercise of Different Intensities and Durations in Type 1 Diabetic Subjects Treated Intensively With a Basal-Bolus Insulin Regimen (Ultralente-Lispro)

Diabetes Care ◽  
2001 ◽  
Vol 24 (4) ◽  
pp. 625-630 ◽  
Author(s):  
R. Rabasa-Lhoret ◽  
J. Bourque ◽  
F. Ducros ◽  
J.-L. Chiasson
Keyword(s):  
Dose Reduction ◽  
Insulin Dose ◽  
Insulin Regimen ◽  
Bolus Insulin ◽  
Basal Bolus

scholarly journals Feasibility of Simplification From a Basal-Bolus Insulin Regimen to a Fixed-Ratio Formulation of Basal Insulin Plus a GLP-1RA or to Basal Insulin Plus an SGLT2 Inhibitor: BEYOND, a Randomized, Pragmatic Trial

2021 ◽  
Author(s):  
Dario Giugliano ◽  
Miriam Longo ◽  
Paola Caruso ◽  
Rosa Di Fraia ◽  
Lorenzo Scappaticcio ◽  
...  
Keyword(s):  
Basal Insulin ◽  
Insulin Dose ◽  
Pragmatic Trial ◽  
Sglt2 Inhibitor ◽  
Fixed Ratio ◽  
Insulin Regimen ◽  
Similar Reduction ◽  
Once Daily ◽  
Bolus Insulin ◽  
Basal Bolus

<b>OBJECTIVE </b> <p><b>BEYOND trial evaluated the feasibility of either basal insulin + GLP-1RA (glucagon-like peptide-1 receptor agonist), or basal insulin + SGLT-2i (sodium-glucose cotransporter-2 inhibitor) to replace a full basal-bolus insulin (BBI) regimen in participants with type 2 diabetes and</b><b> </b><b>inadequate glycemic control. </b></p> <p><b>RESEARCH DESIGN AND METHODS</b> </p> <p><b>Participants were randomized (1:1:1) to: a) intensification of the BBI regimen (n = 101), b) fixed-ratio of basal insulin + GLP-1RA (fixed-combo group, n = 102), and c) combination of basal insulin + SGLT-2i (gliflo-combo group, n = 102). The primary efficacy outcome was change from baseline in HbA1c at 6 months. </b><b></b></p> <p><b>RESULTS</b></p> <p><b>Baseline characteristics were similar among the 3 groups (mean HbA1c was 8.6%, 70 mmol/mol). At 6 months, patients experienced similar reduction in HbA1c level (-0.6 ± 0.8, -0.6 ± 0.8, -0.7 ± 0.9%, mean ± SD, respectively, noninferiority P < 0.001 vs BBI) and the proportion of patients with HbA1c ≤7.5% was also similar (34%, 28% and 27%, respectively, P = 0.489). Total insulin dose increased in BBI group (62 U/day), and decreased both in the fixed-combo and gliflo-combo groups (27 U and 21 U/day, respectively, P <0.01</b><b>). The proportion of patients with hypoglycemia was 17.8%, 7.8% and 5.9%, respectively (P = 0.015). There were 12 drop-outs in the fixed-combo group, 9 in the gliflo-combo group and none in the BBI group. </b><b></b></p> <p><b>CONCLUSIONS</b> </p> <p><b>BEYOND provides evidence that it is possible and safe to switch from a BBI regimen to either a once daily fixed-combo injection or once daily gliflozin added to basal insulin, with similar glucose control, less insulin doses, less injections daily, and less hypoglycemia.</b><b></b></p>

scholarly journals Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis

2020 ◽  
Vol 44 (8) ◽  
pp. 697-700 ◽  
Author(s):  
Max L. Eckstein ◽  
Olivia McCarthy ◽  
Norbert J. Tripolt ◽  
Alexander Müller ◽  
Philipp Birnbaumer ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Dose Reduction ◽  
Insulin Dose ◽  
Carbohydrate Supplementation ◽  
Bolus Insulin

scholarly journals Switching from Twice-Daily Basal Insulin Injections to Once-Daily Insulin Degludec Injection for Basal-Bolus Insulin Regimen in Japanese Patients with Type 1 Diabetes: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yuka Tosaka ◽  
Akio Kanazawa ◽  
Fuki Ikeda ◽  
Mayu Iida ◽  
Junko Sato ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Basal Insulin ◽  
Japanese Patients ◽  
Insulin Degludec ◽  
Insulin Regimen ◽  
Once Daily ◽  
Daily Insulin ◽  
Bolus Insulin ◽  
Basal Bolus

The aim of this study was to investigate the efficacy of insulin degludec used for basal-bolus insulin regimen after switching from twice-daily basal insulin in Japanese patients with type 1 diabetes mellitus. The subjects were 22 type 1 diabetes patients treated with basal-bolus insulin regimen with twice-daily basal insulin. Basal insulin was switched to once-daily injection of insulin degludec with 10% dose reduction. HbA1c and fasting plasma glucose (FPG) were measured before and 12 weeks after switching. The frequency of hypoglycemic episodes, standard deviation (SD) of blood glucose, and mean of daily difference (MODD) were evaluated by continuous glucose monitoring (CGM) before and 4 weeks after switching. HbA1c and FPG before and 12 weeks after switching were comparable (HbA1c 8.5 ± 1.4 versus 8.7 ± 1.6%,P=0.28; FPG 203.2 ± 81.2 versus 206.5 ± 122.4 mg/dL,P=0.91). The frequency of hypoglycemia during nighttime was not significantly different at 4 weeks after switching (14.4 ± 17.0 versus 11.1 ± 15.0%,P=0.45). In addition, SD and MODD before and 4 weeks after switching were also comparable. In conclusion, glycemic control under once-daily insulin degludec injection was almost comparable to that under twice-daily basal insulin injections in Japanese type 1 diabetes patients. This study was registered with ID:UMIN000010474.

scholarly journals Use of Inhaled Insulin in a Basal/Bolus Insulin Regimen in Type 1 Diabetic Subjects: A 6-month, randomized, comparative trial

Diabetes Care ◽  
2005 ◽  
Vol 28 (7) ◽  
pp. 1630-1635 ◽  
Author(s):  
J. S. Skyler ◽  
R. S. Weinstock ◽  
P. Raskin ◽  
J.-F. Yale ◽  
E. Barrett ◽  
...  
Keyword(s):  
Comparative Trial ◽  
Insulin Regimen ◽  
Inhaled Insulin ◽  
Bolus Insulin ◽  
Basal Bolus

scholarly journals Feasibility of Simplification From a Basal-Bolus Insulin Regimen to a Fixed-Ratio Formulation of Basal Insulin Plus a GLP-1RA or to Basal Insulin Plus an SGLT2 Inhibitor: BEYOND, a Randomized, Pragmatic Trial

2021 ◽  
Author(s):  
Dario Giugliano ◽  
Miriam Longo ◽  
Paola Caruso ◽  
Rosa Di Fraia ◽  
Lorenzo Scappaticcio ◽  
...  
Keyword(s):  
Basal Insulin ◽  
Insulin Dose ◽  
Pragmatic Trial ◽  
Sglt2 Inhibitor ◽  
Fixed Ratio ◽  
Insulin Regimen ◽  
Similar Reduction ◽  
Once Daily ◽  
Bolus Insulin ◽  
Basal Bolus

<b>OBJECTIVE </b> <p><b>BEYOND trial evaluated the feasibility of either basal insulin + GLP-1RA (glucagon-like peptide-1 receptor agonist), or basal insulin + SGLT-2i (sodium-glucose cotransporter-2 inhibitor) to replace a full basal-bolus insulin (BBI) regimen in participants with type 2 diabetes and</b><b> </b><b>inadequate glycemic control. </b></p> <p><b>RESEARCH DESIGN AND METHODS</b> </p> <p><b>Participants were randomized (1:1:1) to: a) intensification of the BBI regimen (n = 101), b) fixed-ratio of basal insulin + GLP-1RA (fixed-combo group, n = 102), and c) combination of basal insulin + SGLT-2i (gliflo-combo group, n = 102). The primary efficacy outcome was change from baseline in HbA1c at 6 months. </b><b></b></p> <p><b>RESULTS</b></p> <p><b>Baseline characteristics were similar among the 3 groups (mean HbA1c was 8.6%, 70 mmol/mol). At 6 months, patients experienced similar reduction in HbA1c level (-0.6 ± 0.8, -0.6 ± 0.8, -0.7 ± 0.9%, mean ± SD, respectively, noninferiority P < 0.001 vs BBI) and the proportion of patients with HbA1c ≤7.5% was also similar (34%, 28% and 27%, respectively, P = 0.489). Total insulin dose increased in BBI group (62 U/day), and decreased both in the fixed-combo and gliflo-combo groups (27 U and 21 U/day, respectively, P <0.01</b><b>). The proportion of patients with hypoglycemia was 17.8%, 7.8% and 5.9%, respectively (P = 0.015). There were 12 drop-outs in the fixed-combo group, 9 in the gliflo-combo group and none in the BBI group. </b><b></b></p> <p><b>CONCLUSIONS</b> </p> <p><b>BEYOND provides evidence that it is possible and safe to switch from a BBI regimen to either a once daily fixed-combo injection or once daily gliflozin added to basal insulin, with similar glucose control, less insulin doses, less injections daily, and less hypoglycemia.</b><b></b></p>

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