Madhu S V, Neelaveni K, Pitale Shailesh, Somani Shrikant, Pandey Arun Kumar, Kalra Pramila, Ceaser R, Mohanasundaram Senthilnathan, Mohan Viswanathan
Director-Professor and Head, Dept. Of Endocrinology, University College of Medical Sciences and GTB Hospital, Delhi.
Professor, Department of Endocrinology, Osmania Medical College and General Hospital, Hyderabad, Telangana.
J Assoc Physicians India. 2020 Dec;68(12[Special]):38-42.
Owing to the progressive nature of the disease, patients with type 2 diabetes mellitus (T2DM) eventually require adjustment or titration of insulin doses to achieve the desired glycemic control. Titration inertia, or the inability to dose-titrate, is one of the key barriers to optimized insulin therapy and is common in Asian countries such as India. Simple and effective titration algorithms involving the use of basal insulin, which has the lowest hypoglycemia risk, that can be individualized by physicians and easily followed by patients aid in tackling titration inertia. In this context, insulin glargine 100 U/mL (Gla-100) appears to be the ideal insulin to overcome titration inertia, owing to its low risk of hypoglycemia and effective glycemic control. Different guidelines recommend the use of basal insulin, such as Gla-100, and encourage a patient-centric approach for dose titration. Although the effective implementation of the patient-centric approach in India is challenging, it is nevertheless achievable.
由于该疾病的渐进性,2型糖尿病(T2DM)患者最终需要调整或滴定胰岛素剂量,以实现理想的血糖控制。滴定惰性,即无法进行剂量滴定,是优化胰岛素治疗的关键障碍之一,在印度等亚洲国家很常见。涉及使用低血糖风险最低的基础胰岛素的简单有效滴定算法,可由医生个体化并易于患者遵循,有助于克服滴定惰性。在这种情况下,甘精胰岛素100 U/mL(Gla-100)由于其低血糖风险低和有效的血糖控制,似乎是克服滴定惰性的理想胰岛素。不同的指南推荐使用基础胰岛素,如Gla-100,并鼓励采用以患者为中心的剂量滴定方法。尽管在印度有效实施以患者为中心的方法具有挑战性,但仍是可以实现的。