Self-adjustment of basal insulin dose were proved to be effective and widely used in clinical practice. However, no study compares the efficacy and safety of different self-adjustment regimens of basal insulin in T2DM.
T2DM with inadequate glucose control on OADs who were to start basal insulin from our outpatient clinics were enrolled and randomized to two groups. Patients in Group A were guided to adjust insulin dose 2-6U weekly; those in Group B adjusted insulin dose 2-3U every 3 days. Dose titration was based on self-monitored blood glucose (SMBG) to achieve a target FBG of 6.1mmol/L. The titration regimen is shown in Table.
A total of 648 patients aged 53.9 years old finished the 12-week visits. The baseline characteristics were even between groups. The FBG achieving rates were similar between Group A (75.7%) and Group B (74.4%). Compared with baseline, FBG and HbA1c decreased in both groups (FBG:10.7mmol/L vs. 6.6mmol/L in Group A, 10.8mmol/L vs. 6.5mmol/L in Group B; HbA1c:9.3% vs. 6.9% in group A, 9.5% vs. 6.8% in Group B, respectively, All P<0.001). The reduction of FBG (-4.1mmol/L vs. -4.2mmol/L) and HbA1c (-2.4% vs. -2.7%) were similar between groups, so as the hypoglycemic incidences (17.9% vs. 20.1%). The frequency of SMBG was higher in Group B (5.21 times/week vs. 4.69 times/week, p=0.02).
In conclusion, both self-adjustment regimens in this study are effective and safe in T2DM.
Table. Insulin Titration Protocol.
| Fasting blood glucose (mmol/L) | Dose adjustment (U) | |
| Group A | Group B | |
| <4.4 | -2U | -2∼3U |
| 4.4-6.1 | No change | No change |
| 6.2-7.8 | +2U | +2∼3U |
| 7.9-9.9 | +4U | +2∼3U |
| >10.0 | +6U | +2∼3U |
| Fasting blood glucose (mmol/L) | Dose adjustment (U) | |
| Group A | Group B | |
| <4.4 | -2U | -2∼3U |
| 4.4-6.1 | No change | No change |
| 6.2-7.8 | +2U | +2∼3U |
| 7.9-9.9 | +4U | +2∼3U |
| >10.0 | +6U | +2∼3U |
X. Hu: None. X. Yang: None. W. Xu: None. H.R. Deng: None. X. Guo: None. B. Yao: None. L. Zeng: None. J. Weng: None.
