CGM Evaluation of Glucose Excursions in Basal Insulin Treated T2DM at Fasting Glucose Target

In many clinical trials, basal insulin is titrated to only a fasting glucose goal. The usual final dose is >0.4U/kg. In carefully CGM monitored/titrated studies in both basal insulin alone or in pump-treated T2DM, we have found the basal insulin dose to be <0.3U/kg. This suggests that if guided by a single daily fasting glucose, titration may result in an excessive basal dose. This study will examine that issue.

Inclusion criteria

• Type 2 diabetes
• Age 18 years and above
• Concurrently on +/-thiazolidnedione +/-DDP IV inhibitors +/-metformin +/- glinides and basal insulin analogs
• A1C 10% or below
• Capable of self monitoring glucose at least 4 x a day
• Previously compliant with clinical recommendations
• Fasting blood glucose <110mg/dl average for 3 consecutive days
• BMI <45 kg/m

Exclusion criteria

• Urinary ketosis
• Current or expected alternation in insulin sensitivity such as major surgery, infection, renal failure, glucocorticoid treatment, recent serious hypoglycaemic episode
• Currently participating in another clinical trial
• Using rapid insulin insulin
• Pregnancy or nursing or the intention of becoming pregnant or not using adequate birth control
• Significant liver or heart failure.