Treat to Target Insulin Titration Schedule with Type 2 Diabetes

Description

Riddle et al developed a schedule for titrating insulin doses in type 2 diabetic that would achieve a given target fasting plasma glucose ("treat-to-target"). This can result in effective insulin therapy while minimizing the risk of adverse side effects. The authors are from the Insulin Glargine 4002 Study Investigators.

Parameters:

(1) mean of self-monitored fasting plasma glucose values over past 2 days

(2) severe hypoglycemia in preceding week (defined as need for assistance)

(3) minimum plasma glucose during past week

Initial dose of insulin: 10 IU per day at bedtime

Target fasting plasma glucose: 72 - 100 mg/dL

Mean Fasting Plasma Glucose for Past 2 Day	Increase Over Previous Daily Dose
>= 180 mg/dL	8 IU per day
140 - 179 mg/dL	6 IU per day
120 - 139 mg/dL	4 IU per day
101 - 119 mg/dL	2 IU per day
72 - 100 mg/dL	no change

Minimum Fasting Glucose in Past Week	Severe Hypoglycemia Episode in Past Week	Change in Insulin Dose
56 to 71 mg/dL	absent	no change
< 56 mg/dL	NA	reduce dose 2-4 IU per day
NA	present	reduce dose 2-4 IU per day

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Description

Specialty

Objective

ICD-10

Treat-to-Target Insulin Titration Schedule for Patient with Type 2 Diabetes

Purpose: To titrate a daily insulin dose in a Type 2 diabetic using the "treat to target" algorithm of Riddle et al.

Description

Specialty

Objective

ICD-10