Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Review ArticleClinical Review

Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions

Leigh Perreault, Lauren Vincent, Joshua J. Neumiller and Tricia Santos-Cavaiola
The Journal of the American Board of Family Medicine May 2019, 32 (3) 431-447; DOI: https://doi.org/10.3122/jabfm.2019.03.180162
Leigh Perreault
From Anschutz Medical Campus, University of Colorado, Aurora, CO (LP); University of California–San Diego, San Diego, CA (LV, TS-C); College of Pharmacy, Washington State University, Spokane, WA (JJN).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lauren Vincent
From Anschutz Medical Campus, University of Colorado, Aurora, CO (LP); University of California–San Diego, San Diego, CA (LV, TS-C); College of Pharmacy, Washington State University, Spokane, WA (JJN).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joshua J. Neumiller
From Anschutz Medical Campus, University of Colorado, Aurora, CO (LP); University of California–San Diego, San Diego, CA (LV, TS-C); College of Pharmacy, Washington State University, Spokane, WA (JJN).
PharmD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tricia Santos-Cavaiola
From Anschutz Medical Campus, University of Colorado, Aurora, CO (LP); University of California–San Diego, San Diego, CA (LV, TS-C); College of Pharmacy, Washington State University, Spokane, WA (JJN).
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

References

  1. 1.↵
    1. Rawshani A,
    2. Rawshani A,
    3. Franzén S,
    4. et al
    . Mortality and cardiovascular disease in type 1 and type 2 diabetes. N Engl J Med 2017;376:1407–18.
    OpenUrlCrossRefPubMed
  2. 2.↵
    World Health Organization (WHO). Global report on diabetes: executive summary. 2016. Available from: http://apps.who.int/iris/bitstream/10665/204874/1/WHO_NMH_NVI_16.3_eng.pdf. Accessed December 2018.
  3. 3.↵
    Centers for Disease Control and Prevention (CDC). National diabetes statistics report, 2017. Estimates of diabetes and its burden in the United States. Available from: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed December 2018.
  4. 4.↵
    1. Stratton IM,
    2. Adler AI,
    3. Neil HA,
    4. et al
    . Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405–12.
    OpenUrlAbstract/FREE Full Text
  5. 5.↵
    UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–53.
    OpenUrlCrossRefPubMedWeb of Science
  6. 6.↵
    1. Holman RR,
    2. Paul SK,
    3. Bethel MA,
    4. Matthews DR,
    5. Neil HA
    . 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008;359:1577–89.
    OpenUrlCrossRefPubMedWeb of Science
  7. 7.↵
    1. Carls G,
    2. Huynh J,
    3. Tuttle E,
    4. Yee J,
    5. Edelman SV
    . Achievement of glycated hemoglobin goals in the US remains unchanged through 2014. Diabetes Ther 2017;8:863–73.
    OpenUrlPubMed
  8. 8.↵
    American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care 2018;1:S1–S153.
    OpenUrl
  9. 9.↵
    1. Hirsch IB
    . Insulin analogues. N Engl J Med 2005;352:174–83.
    OpenUrlCrossRefPubMedWeb of Science
  10. 10.↵
    1. Bolli GB,
    2. Riddle MC,
    3. Bergenstal RM,
    4. et al
    . New insulin glargine 300 U/ml compared with glargine 100 U/ml in insulin-naïve people with type 2 diabetes on oral glucose-lowering drugs: a randomized controlled trial (EDITION 3). Diabetes Obes Metab 2015;17:386–94.
    OpenUrlCrossRefPubMed
  11. 11.↵
    1. Zinman B,
    2. Philis-Tsimikas A,
    3. Cariou B,
    4. et al
    . Insulin degludec versus insulin glargine in insulin-naïve patients with type 2 diabetes: a 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 2012;35:2464–71.
    OpenUrlAbstract/FREE Full Text
  12. 12.↵
    1. Hayes RP,
    2. Fitzgerald JT,
    3. Jacober SJ
    . Primary care physician beliefs about insulin initiation in patients with type 2 diabetes. Int J Clin Pract 2008;62:860–8.
    OpenUrlCrossRefPubMedWeb of Science
  13. 13.↵
    1. Beaser RS,
    2. Okeke E,
    3. Neighbours J,
    4. Brown J,
    5. Ronk K,
    6. Wolyniec WW
    . Coordinated primary and specialty care for type 2 diabetes mellitus, guidelines, and systems: an educational needs assessment. Endocr Pract 2011;17:880–90.
    OpenUrlPubMed
  14. 14.↵
    1. Philis-Tsimikas A
    . Initiating basal insulin therapy in type 2 diabetes: practical steps to optimize glycemic control. Am J Med 2013;126:S21–S27.
    OpenUrlCrossRefPubMed
  15. 15.↵
    1. Karter AJ,
    2. Subramanian U,
    3. Saha C,
    4. et al
    . Barriers to insulin initiation: the Translating Research into Action for Diabetes Insulin Starts Project. Diabetes Care 2010;33:733–5.
    OpenUrlAbstract/FREE Full Text
  16. 16.↵
    1. Perez-Nieves M,
    2. Kabul S,
    3. Desai U,
    4. et al
    . Basal insulin persistence, associated factors, and outcomes after treatment initiation among people with type 2 diabetes mellitus in the US. Curr Med Res Opin 2016;32:669–80.
    OpenUrl
  17. 17.↵
    1. Khunti K,
    2. Nikolajsen A,
    3. Thorsted BL,
    4. Andersen M,
    5. Davies MJ,
    6. Paul SK
    . Clinical inertia with regard to intensifying therapy in people with type 2 diabetes treated with basal insulin. Diabetes Obes Metab 2016;18:401–9.
    OpenUrlCrossRefPubMed
  18. 18.↵
    1. Dalal MR,
    2. Grabner M,
    3. Bonine N,
    4. Stephenson JJ,
    5. DiGenio A,
    6. Bieszk N
    . Are patients on basal insulin attaining glycemic targets? Characteristics and goal achievement of patients with type 2 diabetes mellitus treated with basal insulin and physician-perceived barriers to achieving glycemic targets. Diabetes Res Clin Pract 2016;121:17–26.
    OpenUrl
  19. 19.↵
    1. Stark Casagrande S,
    2. Fradkin JE,
    3. Saydah SH,
    4. Rust KF,
    5. Cowie CC
    . The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988–2010. Diabetes Care 2013;36:2271–9.
    OpenUrlAbstract/FREE Full Text
  20. 20.↵
    1. Korytkowski M
    . When oral agents fail: practical barriers to starting insulin. Int J Obes Relat Metab Disord 2002;3:S18–S24.
    OpenUrl
  21. 21.↵
    1. Khunti K,
    2. Millar-Jones D
    . Clinical inertia to insulin initiation and intensification in the UK: a focused literature review. Prim Care Diabetes 2017;11:3–12.
    OpenUrlPubMed
  22. 22.↵
    1. Peyrot M,
    2. Rubin RR,
    3. Khunti K
    . Addressing barriers to initiation of insulin in patients with type 2 diabetes. Prim Care Diabetes 2010;4:S11–S18.
    OpenUrlCrossRefPubMed
  23. 23.↵
    1. Seaquist ER,
    2. Anderson J,
    3. Childs B,
    4. et al
    . Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 2013;36:1384–95.
    OpenUrlAbstract/FREE Full Text
  24. 24.↵
    1. Barendse S,
    2. Singh H,
    3. Frier BM,
    4. Speight J
    . The impact of hypoglycaemia on quality of life and related patient-reported outcomes in Type 2 diabetes: a narrative review. Diabet Med 2012;29:293–302.
    OpenUrlCrossRefPubMed
  25. 25.↵
    1. Berard L,
    2. Bonnemaire M,
    3. Mical M,
    4. Edelman S
    . Insights into optimal basal insulin titration in type 2 diabetes: results of a quantitative survey. Diabetes Obes Metab 2018;20:301–8.
    OpenUrl
  26. 26.↵
    1. Bolli GB,
    2. Riddle MC,
    3. Bergenstal RM,
    4. Wardecki M,
    5. Goyeau H,
    6. Home PD
    . Glycaemic control and hypoglycaemia with insulin glargine 300U/mL versus insulin glargine 100U/mL in insulin-naïve people with type 2 diabetes: 12-month results from the EDITION 3 trial. Diabetes Metab 2017;43:351–8.
    OpenUrlPubMed
  27. 27.↵
    1. Ritzel R,
    2. Roussel R,
    3. Bolli GB,
    4. et al
    . Patient-level meta-analysis of the EDITION 1, 2 and 3 studies: glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus glargine 100 U/ml in people with type 2 diabetes. Diabetes Obes Metab 2015;17:859–67.
    OpenUrlCrossRefPubMed
  28. 28.↵
    1. Russell-Jones D,
    2. Gall MA,
    3. Niemeyer M,
    4. Diamant M,
    5. Del Prato S
    . Insulin degludec results in lower rates of nocturnal hypoglycaemia and fasting plasma glucose vs. insulin glargine: a meta-analysis of seven clinical trials. Nutr Metab Cardiovasc Dis 2015;25:898–905.
    OpenUrl
  29. 29.↵
    1. Brunton SA,
    2. Kruger DF,
    3. Funnell MM
    . Role of emerging insulin technologies in the initiation and intensification of insulin therapy for diabetes in primary care. Clin Diabetes 2016;34:34–43.
    OpenUrlAbstract/FREE Full Text
  30. 30.↵
    1. Gupta S,
    2. Wang H,
    3. Skolnik N,
    4. et al
    . Treatment dosing patterns and clinical outcomes for patients with type 2 diabetes starting or switching to treatment with insulin glargine (300 units per milliliter) in a real-world setting: a retrospective observational study. Adv Ther 2018;35:43–55.
    OpenUrl
  31. 31.↵
    1. Davis SN,
    2. Renda SM
    . Psychological insulin resistance: overcoming barriers to starting insulin therapy. Diabetes Educ 2006;32:146S–52S.
    OpenUrlCrossRefPubMed
  32. 32.↵
    1. Kunt T,
    2. Snoek FJ
    . Barriers to insulin initiation and intensification and how to overcome them. Int J Clin Pract Suppl 2009;6–10.
  33. 33.↵
    1. McFarlane SI
    . Insulin therapy and type 2 diabetes: management of weight gain. J Clin Hypertens (Greenwich) 2009;11:601–7.
    OpenUrlPubMed
  34. 34.↵
    1. Haque M,
    2. Emerson SH,
    3. Dennison CR,
    4. Navsa M,
    5. Levitt NS
    . Barriers to initiating insulin therapy in patients with type 2 diabetes mellitus in public-sector primary health care centres in Cape Town. S Afr Med J 2005;95:798–802.
    OpenUrlPubMedWeb of Science
  35. 35.↵
    1. Hayat AS,
    2. Shaikh N
    . Barriers and myths to initiate insulin therapy for type 2 diabetes mellitus at primary health care centers of Hyderabad district. World Applied Sci 2010;8:66–72.
    OpenUrl
  36. 36.↵
    1. Bin Rsheed A,
    2. Chenoweth I
    . Barriers that practitioners face when initiating insulin therapy in general practice settings and how they can be overcome. World J Diabetes 2017;8:28–39.
    OpenUrl
  37. 37.↵
    1. Brod M,
    2. Kongsø JH,
    3. Lessard S,
    4. Christensen TL
    . Psychological insulin resistance: patient beliefs and implications for diabetes management. Qual Life Res 2009;18:23–32.
    OpenUrlCrossRefPubMedWeb of Science
  38. 38.↵
    1. Davies MJ,
    2. D'Alessio DA,
    3. Fradkin J,
    4. et al
    . Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018;41:2669–701.
    OpenUrlAbstract/FREE Full Text
  39. 39.↵
    1. Garber AJ,
    2. Abrahamson MJ,
    3. Barzilay JI,
    4. et al
    . Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2018 executive summary. Endocr Pract 2018;24:91–120.
    OpenUrlPubMed
  40. 40.↵
    1. Raslová K,
    2. Bogoev M,
    3. Raz I,
    4. Leth G,
    5. Gall MA,
    6. Hâncu N
    . Insulin detemir and insulin aspart: a promising basal-bolus regimen for type 2 diabetes. Diabetes Res Clin Pract 2004;66:193–201.
    OpenUrlCrossRefPubMedWeb of Science
  41. 41.↵
    1. Hermansen K,
    2. Davies M,
    3. Derezinski T,
    4. Martinez Ravn G,
    5. Clauson P,
    6. Home P
    . A 26-week, randomized, parallel, treat-to-target trial comparing insulin detemir with NPH insulin as add-on therapy to oral glucose-lowering drugs in insulin-naïve people with type 2 diabetes. Diabetes Care 2006;29:1269–74.
    OpenUrlAbstract/FREE Full Text
  42. 42.↵
    1. Rodbard HW,
    2. Cariou B,
    3. Zinman B,
    4. et al
    . Comparison of insulin degludec with insulin glargine in insulin-naïve subjects with type 2 diabetes: a 2-year randomized, treat-to-target trial. Diabet Med 2013;30:1298–304.
    OpenUrl
  43. 43.↵
    1. Cichosz SL,
    2. Lundby-Christensen L,
    3. Johansen MD,
    4. et al
    . Prediction of excessive weight gain in insulin treated patients with type 2 diabetes. J Diabetes 2017;9:325–31.
    OpenUrl
  44. 44.↵
    1. van Dieren S,
    2. Czernichow S,
    3. Chalmers J,
    4. et al
    . Weight changes and their predictors amongst 11 140 patients with type 2 diabetes in the ADVANCE trial. Diabetes Obes Metab 2012;14:464–9.
    OpenUrlCrossRefPubMedWeb of Science
  45. 45.↵
    1. Hirsch IB,
    2. Bergenstal RM,
    3. Parkin CG,
    4. Wright E,
    5. Buse JB
    . A real-world approach to insulin therapy in primary care practice. Clin Diabetes 2005;23:78–86.
    OpenUrlFREE Full Text
  46. 46.↵
    1. Polonsky WH,
    2. Jackson RA
    . What's so tough about taking insulin? Addressing the problem of psychological insulin resistance in type 2 diabetes. Clin Diabetes 2004;22:147–50.
    OpenUrlFREE Full Text
  47. 47.↵
    1. Peyrot M,
    2. Rubin RR,
    3. Lauritzen T,
    4. et al
    . Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study. Diabetes Care 2005;28:2673–9.
    OpenUrlAbstract/FREE Full Text
  48. 48.↵
    1. Nakar S,
    2. Yitzhaki G,
    3. Rosenberg R,
    4. Vinker S
    . Transition to insulin in type 2 diabetes: family physicians' misconception of patients' fears contributes to existing barriers. J Diabetes Complications 2007;21:220–6.
    OpenUrlCrossRefPubMedWeb of Science
  49. 49.↵
    1. Gerstein HC,
    2. Bosch J,
    3. Dagenais GR
    ORIGIN trial investigators, Gerstein HC, Bosch J, Dagenais GR. Basal insulin and cardiovascular and other outcomes in dysglycemia. N Engl J Med 2012;367:319–28.
    OpenUrlCrossRefPubMedWeb of Science
  50. 50.↵
    1. Gilbert RE,
    2. Mann JF
    ORIGIN trial investigators, Gilbert RE, Mann JF. Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial. Diabetologia 2014;57:1325–31.
    OpenUrlCrossRefPubMed
  51. 51.↵
    1. Marso SP,
    2. McGuire DK,
    3. Zinman B,
    4. et al
    . Efficacy and safety of degludec versus glargine in type 2 diabetes. N Engl J Med 2017;377:723–32.
    OpenUrlCrossRefPubMed
  52. 52.↵
    1. Yoshioka N,
    2. Ishii H,
    3. Tajima N,
    4. Iwamoto Y
    . Differences in physician and patient perceptions about insulin therapy for management of type 2 diabetes: the DAWN Japan study. Curr Med Res Opin 2014;30:177–83.
    OpenUrl
  53. 53.↵
    Diabetes.org. Frequently asked questions about commercial driver's licenses. Available from: http://www.diabetes.org/living-with-diabetes/know-your-rights/discrimination/drivers-licenses/commercial-drivers-and-diabetes-discrimination/faqs-about-commercial-drivers-licenses.html. Accessed December 2018.
  54. 54.↵
    1. Ratanawongsa N,
    2. Crosson JC,
    3. Schillinger D,
    4. Karter AJ,
    5. Saha CK,
    6. Marrero DG
    . Getting under the skin of clinical inertia in insulin initiation: the Translating Research Into Action for Diabetes (TRIAD) Insulin Starts Project. Diabetes Educ 2012;38:94–100.
    OpenUrlCrossRefPubMed
  55. 55.↵
    1. Karter AJ,
    2. Parker MM,
    3. Moffet HH,
    4. Ahmed AT,
    5. Schmittdiel JA,
    6. Selby JV
    . New prescription medication gaps: a comprehensive measure of adherence to new prescriptions. Health Serv Res 2009;44:1640–61.
    OpenUrlCrossRefPubMedWeb of Science
  56. 56.↵
    International Diabetes Federation (IDF) Clinical Guidelines Task Force. Global guideline for type 2 diabetes. Available from: https://www.idf.org/e-library/guidelines/79-global-guideline-for-type-2-diabetes. Accessed December 2018.
  57. 57.↵
    1. Meneghini L,
    2. Koenen C,
    3. Weng W,
    4. Selam JL
    . The usage of a simplified self-titration dosing guideline (303 Algorithm) for insulin detemir in patients with type 2 diabetes—results of the randomized, controlled PREDICTIVE 303 study. Diabetes Obes Metab 2007;9:902–13.
    OpenUrlCrossRefPubMedWeb of Science
  58. 58.↵
    1. Blonde L,
    2. Merilainen M,
    3. Karwe V,
    4. Raskin P
    , TITRATE Study Group. Patient-directed titration for achieving glycaemic goals using a once-daily basal insulin analogue: an assessment of two different fasting plasma glucose targets—the TITRATE study. Diabetes Obes Metab 2009;11:623–31.
    OpenUrlCrossRefPubMed
  59. 59.↵
    1. Bajaj HS,
    2. Venn K,
    3. Ye C,
    4. Aronson R
    . Randomized trial of long-acting insulin glargine titration web tool (LTHome) versus enhanced usual therapy of glargine titration (INNOVATE Trial). Diabetes Technol Ther 2016;18:610–5.
    OpenUrl
  60. 60.↵
    1. Padhye NS,
    2. Jing W
    . Pattern of active and inactive sequences of diabetes self-monitoring in mobile phone and paper diary users. Conf Proc IEEE Eng Med Biol Soc 2015;2015:7630–3.
    OpenUrl
  61. 61.↵
    US Food and Drug Administration (FDA). My Dose Coach Section 510(k) approval. Available from: https://www.accessdata.fda.gov/cdrh_docs/pdf16/K163099.pdf. Accessed December 2018.
  62. 62.↵
    Mobihealthnews. Sanofi gets FDA clearance for insulin dose calculator app. Available from: http://www.mobihealthnews.com/content/sanofi-gets-fda-clearance-insulin-dose-calculator-app. Accessed December 2018.
  63. 63.↵
    diaTribe. FDA clears “My Dose Coach” app to optimize basal insulin dosing. Available from: https://diatribe.org/fda-clears-my-dose-coach-app-to-optimize-basal-insulin-dosing. Accessed December 2018.
  64. 64.↵
    1. Goldman J,
    2. Gill J,
    3. Horn T,
    4. Reid T,
    5. Strong J,
    6. Polonsky W
    . Improved treatment engagement among patients receiving insulin glargine 300 units/mL who enrolled and received live support through the COACH patient support program. Presented at the American Association of Clinical Endocrinologists (AACE) Annual Meeting May 3–7, 2017, Austin, TX.
  65. 65.↵
    1. Mehmet S,
    2. Hussey C,
    3. Ibrahim S
    . Patients' perceptions of injecting insulin and self-monitoring of blood glucose in the presence of others. Pract Diabetes 2015;32:59–63.
    OpenUrl
  66. 66.↵
    1. Funnell MM
    . Lessons from DAWN: implementing effective insulin therapy. The Internet Journal of Advanced Nursing Practice 2008;10:1–10.
    OpenUrl
  67. 67.↵
    1. Kruger DF,
    2. LaRue S,
    3. Estepa P
    . Recognition of and steps to mitigate anxiety and fear of pain in injectable diabetes treatment. Diabetes Metab Syndr Obes 2015;8:49–56.
    OpenUrlPubMed
  68. 68.↵
    1. Hermanns N,
    2. Mahr M,
    3. Kulzer B,
    4. Skovlund SE,
    5. Haak T
    . Barriers towards insulin therapy in type 2 diabetic patients: results of an observational longitudinal study. Health Qual Life Outcomes 2010;8:113.
    OpenUrlCrossRefPubMed
  69. 69.↵
    1. Mollema ED,
    2. Snoek FJ,
    3. Pouwer F,
    4. Heine RJ,
    5. van der Ploeg HM
    . Diabetes Fear of Injecting and Self-testing Questionnaire: a psychometric evaluation. Diabetes Care 2000;23:765–9.
    OpenUrlAbstract/FREE Full Text
  70. 70.↵
    1. Uman LS,
    2. Chambers CT,
    3. McGrath PJ,
    4. Kisely S
    . A systematic review of randomized controlled trials examining psychological interventions for needle-related procedural pain and distress in children and adolescents: an abbreviated Cochrane review. J Pediatr Psychol 2008;33:842–54.
    OpenUrlCrossRefPubMedWeb of Science
  71. 71.↵
    1. Inzucchi SE,
    2. Bergenstal RM,
    3. Buse JB,
    4. et al
    . Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2015;38:140–9.
    OpenUrlFREE Full Text
  72. 72.↵
    1. Rosenstock J,
    2. Hollander P,
    3. Bhargava A,
    4. et al
    . Similar efficacy and safety of LY2963016 insulin glargine and insulin glargine (Lantus®) in patients with type 2 diabetes who were insulin-naïve or previously treated with insulin glargine: a randomized, double-blind controlled trial (the ELEMENT 2 study). Diabetes Obes Metab 2015;17:734–41.
    OpenUrl
  73. 73.↵
    1. Blevins TC,
    2. Dahl D,
    3. Rosenstock J,
    4. et al
    . Efficacy and safety of LY2963016 insulin glargine compared with insulin glargine (Lantus®) in patients with type 1 diabetes in a randomized controlled trial: The ELEMENT 1 study. Diabetes Obes Metab 2015;17:726–33.
    OpenUrl
  74. 74.↵
    US Food and Drug Administration (FDA). Biosimilars. Available from: https://www.fda.gov/drugs/developmentapprovalprocess/howdrugsaredevelopedandapproved/approvalapplications/therapeuticbiologicapplications/biosimilars/. Accessed December 2018.
  75. 75.↵
    1. Bailey TS,
    2. Pettus J,
    3. Roussel R,
    4. et al
    . Morning administration of 0.4U/kg/day insulin glargine 300U/mL provides less fluctuating 24-hour pharmacodynamics and more even pharmacokinetic profiles compared with insulin degludec 100U/mL in type 1 diabetes. Diabetes Metab 2018;44:15–21.
    OpenUrlPubMed
  76. 76.↵
    1. Becker RH,
    2. Dahmen R,
    3. Bergmann K,
    4. Lehmann A,
    5. Jax T,
    6. Heise T
    . New insulin glargine 300 unit. mL-1 provides a more even activity profile and prolonged glycemic control at steady state compared with insulin glargine 100 unit. mL-1. Diabetes Care 2015;38:637–43.
    OpenUrlAbstract/FREE Full Text
  77. 77.↵
    1. Bergenstal RM,
    2. Bailey TS,
    3. Rodbard D,
    4. et al
    . Comparison of insulin glargine 300 units/ml and 100 units/ml in adults with type 1 diabetes: continuous glucose monitoring profiles and variability using morning or evening injections. Diabetes Care 2017;40:554–60.
    OpenUrlAbstract/FREE Full Text
  78. 78.↵
    1. Shiramoto M,
    2. Eto T,
    3. Irie S,
    4. et al
    . Single-dose new insulin glargine 300 U/ml provides prolonged, stable glycaemic control in Japanese and European people with type 1 diabetes. Diabetes Obes Metab 2015;17:254–60.
    OpenUrlCrossRefPubMed
  79. 79.↵
    1. Gough SC,
    2. Bhargava A,
    3. Jain R,
    4. Mersebach H,
    5. Rasmussen S,
    6. Bergenstal RM
    . Low-volume insulin degludec 200 units/ml once daily improves glycemic control similarly to insulin glargine with a low risk of hypoglycemia in insulin-naïve patients with type 2 diabetes: a 26-week, randomized, controlled, multinational, treat-to-target trial: the BEGIN LOW VOLUME trial. Diabetes Care 2013;36:2536–42.
    OpenUrlAbstract/FREE Full Text
  80. 80.↵
    1. Zhou FL,
    2. Ye F,
    3. Berhanu P,
    4. et al
    . Real-world evidence concerning clinical and economic outcomes of switching to insulin glargine 300 units/mL vs other basal insulins in patients with type 2 diabetes using basal insulin. Diabetes Obes Metab 2018;20:1293–7.
    OpenUrl
  81. 81.↵
    1. Blonde L,
    2. Zhou FL,
    3. Bosnyak Z,
    4. et al
    . Real-world evidence demonstrates comparable clinical outcomes of switching from insulin glargine 100 U/mL (Gla-100) to insulin glargine 300 U/mL (Gla-300) vs insulin degludec (IDeg) in patients with type 2 diabetes. Presented at the 15th Annual World Congress on Insulin Resistance, Diabetes & Cardiovascular Disease (WCIRDC), November 30–December 2, 2017, Los Angeles, CA.
  82. 82.↵
    1. Meneghini L,
    2. Zhou FL,
    3. Bosnyak Z,
    4. Berria R,
    5. Jimenez J,
    6. Bailey TS
    . Hypoglycemia risk associated with basal insulin use in type 2 diabetes (T2DM): the LIGHTNING study. Presented at the 11th Annual Conference on Advanced Technologies and Treatments for Diabetes (ATTD), February 14–17, 2018, Vienna, Austria.
  83. 83.↵
    1. Landstedt-Hallin L,
    2. Gundgaard J,
    3. Ericsson Å,
    4. Ellfors-Zetterlund S
    . Cost-effectiveness of switching to insulin degludec from other basal insulins: evidence from Swedish real-world data. Curr Med Res Opin 2017;33:647–55.
    OpenUrl
  84. 84.↵
    1. Bohn B,
    2. Zimmermann A,
    3. Wagner C,
    4. et al
    . Real-life experience of patients starting insulin degludec. A multicenter analysis of 1064 subjects from the German/Austrian DPV registry. Diabetes Res Clin Pract 2017;129:52–8.
    OpenUrl
  85. 85.↵
    1. Riddle MC,
    2. Bolli GB,
    3. Home PD,
    4. et al
    . Efficacy and safety of flexible versus fixed dosing intervals of insulin glargine 300 U/mL in people with type 2 diabetes. Diabetes Technol Ther 2016;18:252–7.
    OpenUrlCrossRefPubMed
  86. 86.↵
    1. Meneghini L,
    2. Atkin SL,
    3. Gough SC,
    4. et al
    . The efficacy and safety of insulin degludec given in variable once-daily dosing intervals compared with insulin glargine and insulin degludec dosed at the same time daily: a 26-week, randomized, open-label, parallel-group, treat-to-target trial in individuals with type 2 diabetes. Diabetes Care 2013;36:858–64.
    OpenUrlAbstract/FREE Full Text
  87. 87.↵
    Toujeo (insulin glargine injection) U-300 for subcutaneous use. Prescribing information. Bridgewater, NJ: Sanofi-Aventis US, LLC; September 2015. Available from: http://products.sanofi.us/toujeo/toujeo.pdf. Accessed December 2018.
  88. 88.↵
    Tresiba (insulin degludec injection). Prescribing information. Plainsboro, NJ: Novo Nordisk, Inc. December 2016. Available from: http://www.novo-pi.com/tresiba.pdf. Accessed December 2018.
  89. 89.↵
    1. Heise T,
    2. Meneghini LF
    . Insulin stacking versus therapeutic accumulation: understanding the differences. Endocr Pract 2014;20:75–83.
    OpenUrlCrossRefPubMed
  90. 90.↵
    1. Yale JF,
    2. Berard L,
    3. Groleau M,
    4. Javadi P,
    5. Stewart J,
    6. Harris SB
    . TITRATION: a randomized study to assess 2 treatment algorithms with new insulin glargine 300 units/mL. Can J Diabetes 2017;41:478–84.
    OpenUrl
  91. 91.↵
    1. Berard L,
    2. Antonishyn N,
    3. Arcudi K,
    4. et al
    . Insulin matters: a practical approach to basal insulin management in type 2 diabetes. Diabetes Ther 2018;9:501–19.
    OpenUrl
  92. 92.↵
    1. Deakin T,
    2. McShane CE,
    3. Cade JE,
    4. Williams RD
    . Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2005:CD003417.
  93. 93.↵
    Tresiba® dosing and device. Available from: https://www.tresibapro.com/dosing-and-device/starting-patients.html. Accessed December 2018.
  94. 94.↵
    Toujeo® insulin dosing and titration calculator. Available from: https://www.toujeopro.com/toujeo-insulin-dosing-and-titration-calculator. Accessed December 2018.
  95. 95.↵
    Lantus® prescribing information. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/021081s034lbl.pdf. Accessed December 2018.
  96. 96.↵
    Levemir® prescribing information. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021536s031s051lbl.pdf. Accessed December 2018.
  97. 97.↵
    Basaglar® prescribing information. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/205692lbl.pdf. Accessed December 2018.
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 32 (3)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 3
May-June 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
3 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions
Leigh Perreault, Lauren Vincent, Joshua J. Neumiller, Tricia Santos-Cavaiola
The Journal of the American Board of Family Medicine May 2019, 32 (3) 431-447; DOI: 10.3122/jabfm.2019.03.180162

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions
Leigh Perreault, Lauren Vincent, Joshua J. Neumiller, Tricia Santos-Cavaiola
The Journal of the American Board of Family Medicine May 2019, 32 (3) 431-447; DOI: 10.3122/jabfm.2019.03.180162
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Conclusions
    • Acknowledgments
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Post Hoc Analysis Evaluating the Impact of Antihyperglycemic Background Therapies on Attainment of A1C Targets Without Hypoglycemia in the ACHIEVE Control Pragmatic, Real-Life Study
  • Evaluation of Clinical Outcomes With the V-Go Wearable Insulin Delivery Device in Patients With Type 2 Diabetes
  • The Most Frequently Read Articles of 2019
  • Family Medicine: Data Driven Practice with Emphasis on Underserved Patients
  • Google Scholar

More in this TOC Section

  • Interpretating Normal Values and Reference Ranges for Laboratory Tests
  • Non-Surgical Management of Urinary Incontinence
  • Screening and Diagnosis of Type 2 Diabetes in Sickle Cell Disease
Show more Clinical Review

Similar Articles

Keywords

  • Hyperglycemia
  • Hypoglycemia
  • Insulin
  • Primary Care Physicians
  • Primary Health Care
  • Type 2 Diabetes Mellitus
  • Weight Gain

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire