Basal plus strategy implementation in clinical practiceArticle list
- Á. Merchante Alfaro1, F.J. García Soidán2, F. Álvarez Guisasola3, J.L. Bianchi Llave4, F. Carral San Laureano5, P. Checa Zornoza6, F. Losada Viñau7, A. Marco8, A. Pérez Lázaro9, M. Pérez-Maraver10, C. Yoldi11, C. Zafón LLopis12, F.J. Ampudia-Blasco13
Insulin treatment may be necessary in type 2 diabetes, because many patients are not able over the time to achieve or maintain glycemic targets
to prevent chronic complications associated to sustained hyperglycemia. Initially, addition of basal insulin to previous treatment with oral agents
is the most commonly used regimen. This strategy is based on optimal control of fasting plasma glucose. However, a significant proportion of patients
does not achieve or maintain HbA1c target ¡ 7%, because they show excessive postprandial glucose values. Therefore, the next step for intensification of treatment might be the addition of a single dose of prandial insulin before the main meal, which is associated with the greatest postprandial glucose excursion (basal plus strategy), maintaining previous treatment with basal insulin and oral agents. This regimen has demonstrated
to be easy to use, effective and appropriate for many patients. Furthermore, if necessary, it makes easier progressive introduction of additional
injections of prandial insulin until the basal bolus strategy. In this manuscript, recommendations from a multidisciplinary working group are
summarized for an adequate implementation of the basal plus strategy in the routine clinical practice.
Correspondencia: Á. Merchante Alfaro. Hospital Lluís Alcanyís.
46800 Xàtiva (Valencia).
Correo electrónico: firstname.lastname@example.org
Keywordsinsulin resistance insulin type 2 diabetes Postprandial glycemia basal plus basal-bolus therapy
(Original in spanish)