The American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) indicate that patients who have type 2 diabetes can improve their glycemic control with a dose plan for titrating insulin doses themselves according to self-monitored fasting blood glucose (FBG).1
When a patient’s A1C is less than 8%, the recommended total daily dose (TDD) of basal insulin should be 0.1 to 0.2 units/kg
When the A1C is greater than 8%, the recommended TDD of basal insulin should be 0.2 to 0.3 units/kg
Fixed regimen: Increase TDD by 2 units
FBG >180 mg/dL: add 20% of TDD
FBG = 140 to 180 mg/dL: add 10% of TDD
FBG = 110 to 139 mg/dL: add 1 unit
If hypoglycemia is evident, reduce the TDD by the following:
Blood glucose <70 mg/dL: 10% to 20%
Blood glucose <40 mg/dL: 20% to 40%
Consider discontinuing or reducing sulfonylurea after starting basal insulin (basal analogs preferred to neutral protamine Hagedorn).
My Dose Coach uses your individualized dose instructions to help adult patients who have type 2 diabetes with long-acting basal insulin titration based on each patient’s FBG level and history of hypoglycemia. It’s a way to initiate and update basal insulin dosing according to your custom titration instructions via an HCP Web portal and a patient’s smartphone.
1. Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm. Endocr Pract. 2016;22:84-113.