BE-SMART (Basal Early Strategies to Maximize HbA1c Reduction with Oral Therapy): Expert Opinion.

Basal insulin Degludec Detemir Glargine Hypoglycemia Titration Type 2 diabetes mellitus

Journal

Diabetes therapy : research, treatment and education of diabetes and related disorders
ISSN: 1869-6953
Titre abrégé: Diabetes Ther
Pays: United States
ID NLM: 101539025

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 19 03 2019
pubmed: 19 5 2019
medline: 19 5 2019
entrez: 19 5 2019
Statut: ppublish

Résumé

The past three decades have seen a quadruple rise in the number of people affected by diabetes mellitus worldwide, with the disease being the ninth major cause of mortality. Type 2 diabetes mellitus (T2DM) often remains undiagnosed for several years due to its asymptomatic nature during the initial stages. In India, 70% of diagnosed diabetes cases remain uncontrolled. Current guidelines endorse the initiation of insulin early in the course of the disease, specifically in patients with HbA1c > 10%, as the use of oral agents alone is unlikely to achieve glycemic targets. Early insulin initiation and optimization of glycemic control using insulin titration algorithms and patient empowerment can facilitate the effective management of uncontrolled diabetes. Early glucose control has sustained benefits in people with diabetes. However, insulin initiation, dose adjustment, and the need to repeatedly assess blood glucose levels are often perplexing for both physicians and patients, and there are misconceptions and concerns regarding its use. Hence, an early transition to insulin and ideal intensification of treatment may aid in delaying the onset of diabetes complications. This opinion statement was formulated by an expert panel on the basis of existing guidelines, clinical experience, and economic and cultural contexts. The statement stresses the timely and appropriate use of basal insulin in T2DM. It focuses on the seven vital Ts-treatment initiation, timing of administration, transportation and storage, technique of administration, targets for titration, tablets, and tools for monitoring.Funding: Sanofi.

Identifiants

pubmed: 31102253
doi: 10.1007/s13300-019-0629-z
pii: 10.1007/s13300-019-0629-z
pmc: PMC6612329
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

1189-1204

Références

J Korean Med Sci. 2014 Jan;29(1):90-7
pubmed: 24431911
Diabetes Obes Metab. 2013 Aug;15(8):690-700
pubmed: 23253563
Arch Med Sci. 2015 Aug 12;11(4):840-8
pubmed: 26322096
N Engl J Med. 2012 Jul 26;367(4):319-28
pubmed: 22686416
J Multidiscip Healthc. 2014 Jul 02;7:267-82
pubmed: 25061317
Diabetes Care. 2011 Oct;34(10):2333-5
pubmed: 21949226
Diabetes Care. 2003 Jan;26 Suppl 1:S28-32
pubmed: 12502617
Int J Clin Exp Pathol. 2015 Nov 01;8(11):14141-50
pubmed: 26823727
Diabetes Obes Metab. 2018 Mar;20(3):488-496
pubmed: 29053215
Mayo Clin Proc. 2016 Sep;91(9):1231-55
pubmed: 27594187
Diabetol Metab Syndr. 2018 Apr 3;10:26
pubmed: 29636825
Indian J Endocrinol Metab. 2013 Jul;17(4):594-601
pubmed: 23961474
Nat Rev Endocrinol. 2018 Feb;14(2):88-98
pubmed: 29219149
Diabetes Care. 2013 Apr;36(4):858-64
pubmed: 23340894
Diabet Med. 2006 Jul;23(7):736-42
pubmed: 16842477
Indian J Endocrinol Metab. 2016 May-Jun;20(3):408-11
pubmed: 27186563
Eur Endocrinol. 2018 May;14(Suppl1):2-9
pubmed: 30034546
Diabetes Care. 2002 Dec;25(12):2133-40
pubmed: 12453950
Vasc Health Risk Manag. 2008;4(6):1189-95
pubmed: 19337532
J Diabetes Metab Disord. 2013 Mar 05;12(1):14
pubmed: 23497559
Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S432-3
pubmed: 23565455
MedGenMed. 2006 Nov 15;8(4):34
pubmed: 17415316
Indian J Endocrinol Metab. 2015 Sep-Oct;19(5):577-96
pubmed: 26425465
Diabetes Care. 2005 Feb;28(2):419-20
pubmed: 15677803
Diabetes Obes Metab. 2014 Mar;16(3):193-205
pubmed: 23668598
Drug Saf. 2004;27(12):841-56
pubmed: 15366973
Indian J Endocrinol Metab. 2017 May-Jun;21(3):482-483
pubmed: 28553610
J Clin Endocrinol Metab. 2010 May;95(5):2163-71
pubmed: 20237169
J Assoc Physicians India. 2014 Jul;62(7 Suppl):49-54
pubmed: 25668937
Indian J Endocrinol Metab. 2016 Jan-Feb;20(1):22-31
pubmed: 26904465
Diabetes Care. 2013 Aug;36 Suppl 2:S259-63
pubmed: 23882055
BMJ Open Diabetes Res Care. 2018 Jul 10;6(1):e000519
pubmed: 30023075
PLoS One. 2014 Mar 10;9(3):e87799
pubmed: 24614911
J Assoc Physicians India. 2011 Apr;59 Suppl:8-12
pubmed: 21818992
Diabetes Ther. 2019 Apr;10(2):341-366
pubmed: 30815830
Indian J Endocrinol Metab. 2017 Jul-Aug;21(4):600-617
pubmed: 28670547
Diabetes Care. 2005 Jun;28(6):1282-8
pubmed: 15920040
Clin Diabetes. 2019 Jan;37(1):11-34
pubmed: 30705493
BMJ Open Diabetes Res Care. 2015 Jun 16;3(1):e000108
pubmed: 26113983
J Diabetes Complications. 2015 Mar;29(2):295-301
pubmed: 25536866
Curr Vasc Pharmacol. 2009 Jan;7(1):68-74
pubmed: 19149642
Diabetes Technol Ther. 2013 Sep;15(9):776-85
pubmed: 23786228

Auteurs

Sarita Bajaj (S)

Department of Medicine, MLN Medical College, Allahabad, India.

A K Das (AK)

Department of Medicine, JIPMER, Puducherry, India.

Sanjay Kalra (S)

Department of Diabetes and Endocrinology, Bharti Hospital, Karnal, India. brideknl@gmail.com.

Rakesh Sahay (R)

Department of Endocrinology, Osmania Medical College and Hospital, Hyderabad, India.

Banshi Saboo (B)

Diacare-Diabetes Care and Hormone Clinic, Ahmedabad, India.

Sambit Das (S)

Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India.

M Shunmugavelu (M)

Trichy Diabetes Speciality Centre (P) Ltd., Trichy, India.

Jubbin Jacob (J)

Endocrine and Diabetes Unit, Department of Medicine, Christian Medical College and Hospital, Ludhiana, India.

Gagan Priya (G)

Fortis Hospital, Mohali, India.

Deepak Khandelwal (D)

Department of Endocrinology, Maharaja Agrasen Hospital, Delhi, India.

Deep Dutta (D)

Department of Endocrinology, Diabetology and Metabolic Disorders, Venkateshwar Hospital, New Delhi, India.

Manoj Chawla (M)

Lina Diabetes Care and Mumbai Diabetes Research Centre, Mumbai, India.

Vineet Surana (V)

Manipal Hospitals, New Delhi, India.

Mangesh Tiwaskar (M)

Shilpa Medical Research Centre, Mumbai, India.

Ameya Joshi (A)

Bhaktivedanta Hospital and Research Institute, Thane, India.

Pradip Krishna Shrestha (PK)

Nidan Hospital Pvt. Ltd., Patan, Nepal.

Jyoti Bhattarai (J)

Metro Kathmandu Hospital, Kathmandu, Nepal.

Bishwajit Bhowmik (B)

Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh.

Tint Swe Latt (TS)

University of Medicine 2, Yangon, Myanmar.

Than Than Aye (TT)

University of Medicine 2, Myanmar Society of Endocrinology and Metabolism (MSEM), Yangon, Myanmar.

G Vijayakumar (G)

Apollo Specialty Hospital and Diabetes Medicare Centre, Chennai, India.

Manash Baruah (M)

Excel Care Hospitals, Guwahati, India.

Fatema Jawad (F)

Journal of Pakistan Medical Association, Karachi, Pakistan.

A G Unnikrishnan (AG)

Chellaram Diabetes Hospital, Pune, India.

Subhankar Chowdhury (S)

Department of Endocrinology, IPGME&R and SSKM Hospital, Kolkata, India.

Md Faruqe Pathan (MF)

Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh.

Noel Somasundaram (N)

Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Manilka Sumanathilaka (M)

National Hospital of Sri Lanka, Sri Lanka College of Endocrinologists, Colombo, Sri Lanka.

Abbas Raza (A)

Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.

Silver K Bahendeka (SK)

Mother Kevin Postgraduate Medical School, Martyrs University, St. Francis Hospital, Kampala, Uganda.

Ankia Coetzee (A)

Division of Endocrinology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Society for Endocrinology, Diabetes and Metabolism, Cape Town, South Africa.

Sundeep Ruder (S)

Life Fourways Hospital, University of the Witwatersrand, Cape Town, South Africa.

Kaushik Ramaiya (K)

Shree Hindu Mandal Hospital, Dar e Salaam, Tanzania.

Roberta Lamptey (R)

Korle Bu Teaching Hospital, University of Ghana School of Medicine and Dentistry, Accra, Ghana.

Charlotte Bavuma (C)

College of Medicine and Health Science, University of Rwanda, Kigali, Rwanda.

Khalid Shaikh (K)

Department of Diabetes, Faculty of Internal Medicine, Royal Oman Police Hospital, Muscat, Oman.

Andrew Uloko (A)

College of Health Sciences, Bayero University, Kano, Nigeria.

Sandeep Chaudhary (S)

NMC Speciality Hospital, Dubai, UAE.

Abdurezak Ahmed Abdela (AA)

Department of Internal Medicine, School of Medicine, CHS, Addis Ababa University, Addis Ababa, Ethiopia.

Zhanay Akanov (Z)

Kazakh Society for Study of Diabetes, Almaty, Kazakhstan.

Joel Rodrìguez-Saldaña (J)

Multidisciplinary Diabetes Center of Mexico, Mexico City, Mexico.

Raquel Faradji (R)

Clinica EnDi, RENACED Diabetes Tipo 1, Escuela de Medicina, TEC-ABC, Centro Médico ABC, Sociedad Mexicana de Nutrición y Endocrinología, Mexico City, Mexico.

Armindo Tiago (A)

Mozambican Diabetic Association, Maputo Central Hospital, Maputo, Mozambique.

Ahmed Reja (A)

Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia.

Leszek Czupryniak (L)

Department of Diabetology and Internal Medicine, Central University Hospital, Warsaw Medical University, Warsaw, Poland.

Classifications MeSH