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Patient‐directed titration for achieving glycaemic goals using a once‐daily basal insulin analogue: an assessment of two different fasting plasma glucose targets ‐ the TITRATE TM study
Abstract
Aims To compare efficacy and safety of two fasting plasma glucose (FPG) titration targets [4.4-6.1 mmol/l (80-110 mg/dl) and 3.9-5.0 mmol/l (70-90 mg/dl)] using a patient-directed, treat-to-target algorithm for once-daily basal insulin in insulin-naïve subjects with type 2 diabetes suboptimally treated with oral antidiabetes drugs (OADs). Methods In this 20-week, randomized, controlled, open-label, multicentre, treat-to-target study, 244 insulin-naïve subjects with type 2 diabetes, HbA(1c)>or=7.0 and Results Overall, the combined treatment groups achieved a mean HbA(1c) level of 6.9% at the end of the study. Substantial reductions in HbA(1c) were seen in both treatment groups, with the majority of subjects in both titration groups at the end of the study achieving the American Diabetes Association (ADA)-recommended HbA(1c) level of Conclusions The 3.9-5.0 mmol/l FPG target showed superior efficacy compared with the 4.4-6.1 mmol/l target, although both FPG titration targets resulted in substantial reductions of HbA(1c) in patients with type 2 diabetes using a patient-directed insulin titration algorithm. A majority of subjects in both titration groups achieved the ADA-recommended guideline of <7% HbA(1c) at the end of the study with low rates of hypoglycaemia. These data indicate that lowering the fasting glucose target using a self-directed titration algorithm with once-daily detemir is safe and increases the likelihood of achieving the target level of HbA(1c). Indeed, using…
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Instruction of individuals with type 2 diabetes initiating insulin on self-titration of insulin doses based on glucose monitoring improves glycemic management.
“For example, instruction of individuals with type 2 diabetes initiating insulin on self-titration of insulin doses based on glucose monitoring improves glycemic management (163).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [163]
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Metadata
- Authors
- Blonde, L., Merilainen, M., Karwe, V., Raskin, P., & TITRATE™ Study Group
- Affiliations
- Ochsner Medical Center (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Blonde, L.
- ORCID
- Blonde, L.
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2009-05-06
- Volume
- 11
- Issue
- 6
- Pages
- 623-631
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2103692362
- Cited by
- 180
- References
- 4
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 9 · 2019: 10 · 2018: 9 · 2017: 6 · 2016: 9 · 2015: 14 · 2014: 15 · 2013: 27 · 2012: 21
- FWCI
- 14.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, basal insulin, insulin detemir, fasting blood glucose, glycemic control, HbA1c, insulin-naive patients, suboptimal treatment, insulin initiation, glycemic variability, hypoglycemia
- MeSH terms
- Insulin Detemir, Algorithms, Blood Glucose, Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Fasting, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Patient Participation, Blood Glucose Self-Monitoring, Treatment Outcome, Insulin, Long-Acting
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