The combination of basal and meal-time insulin therapy has a long history, growing
from the introduction of basal insulin in the 1940–1950s, and the realization that
this could not cover peri-meal needs. The explanation for this was not really clear
until the advent of radioimmunoassay in the 1970–1980s, and indeed it was only when
a small amount of C-peptide became available to investigational use that physiological
meal-time insulin secretion could be quantified as around 50% of total daily requirement
[
[1]
]. Meanwhile the advent of continuous subcutaneous insulin therapy (CSII) allowed unmodified
insulin to be used as basal therapy [
[2]
], only to be challenged by Robert Turner and colleagues as being potentially matched
by meal-time + basal combination therapy, commonly designated multiple daily injections
(MDI) [
[3]
]. Since that time meal-time + basal insulin regimens have been the cornerstone of
insulin therapy in type 1 diabetes (where pumps are not desired or feasible), and
have been the final line of the type 2 diabetes therapeutic algorithm as islet B-cell
function reached its terminal decline [
4
,
Clinical Guidelines Task Force. Global guideline for type 2 diabetes. Brussels: International Diabetes Federation; 2005. www.idf.org.
5
].- Inzucchi S.E.
- Bergenstal R.M.
- Buse J.B.
- et al.
Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position
statement of the American Diabetes Association (ADA) and the European Association
for the Study of Diabetes (EASD).
Diab. Care. 2012; 35 (Diabetologia 2012; 55: 1577–1596. https://doi.org/10.1007/s00125-012-2534-0): 1364-1379https://doi.org/10.2337/dc12-0413
Keyword
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References
- Basal and 24-h C-peptide and insulin secretion rate in normal man.Diabetologia. 1987; 30: 16-21
- Continuous subcutaneous insulin infusion: an approach to achieving normoglycaemia.BMJ. 1978; i: 204-207
- Continuous subcutaneous insulin infusion or subcutaneous insulin injections.Lancet. 1979; 314: 481
Clinical Guidelines Task Force. Global guideline for type 2 diabetes. Brussels: International Diabetes Federation; 2005. www.idf.org.
- Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).Diab. Care. 2012; 35 (Diabetologia 2012; 55: 1577–1596. https://doi.org/10.1007/s00125-012-2534-0): 1364-1379https://doi.org/10.2337/dc12-0413
- Beyond basal-bolus insulin regimen: is it still the ultimate chance for therapy in diabetes?.Diabetes Res Clin Pract. 2019; 157107922
- Fast-Acting Insulin Aspart: A Review of its Pharmacokinetic and Pharmacodynamic Properties and the Clinical Consequences.Clinical Pharmacokinetics. 2019; On line ahead of printhttps://doi.org/10.1007/s40262-019-00834-5
- Three-year efficacy of complex insulin regimens in type 2 diabetes.N Engl J Med. 2009; 361: 1736-1747
- Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).Diabetologia. 2018; 2018: 2461-2498https://doi.org/10.1007/s00125-018-4729-5
- Advancing basal insulin replacement in type 2 diabetes inadequately controlled with insulin glargine plus oral agents: a comparison of adding albiglutide, a weekly GLP-1 receptor agonist, versus thrice-daily prandial insulin lispro.Diabetes Care. 2014; 37: 2317-2325
Rosenstock J, Nino A, Soffer J, Mallory J, Erskine L, Acusta A, et al. Near-normoglycemia, with meaningful discontinuations of prandial insulin, by adding weekly albiglutide to uncontrolled basal/bolus insulin-treated type 2 diabetes. In EASD Annual Meeting, 2018, Abstract 41. https://www.easd.org/virtualmeeting/home.html [last accessed 01 November 2019].
- Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes.Diabetes Obes Metab. 2010; 12: 167-177
- Cardiovascular outcome trials of glucose-lowering medications: an update.Diabetologia. 2019; 62: 357-369https://doi.org/10.1007/s00125-018-4801-1
- International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) Inhibitors.Diabetes Care. 2019; 42: 1147-1154https://doi.org/10.2337/dc18-2316
AstraZeneca UK Ltd, Forixa 5 mg film-coated tables SmPC. www.medicines.org.uk/emc/product/2865/smpc [last accessed 01 November 2019].
- The hybrid closed-loop system: evolution and practical applications.Diabetes Technol Ther. 2018; 20: S216-S223https://doi.org/10.1089/dia.2018.0091
Article info
Publication history
Published online: November 09, 2019
Accepted:
November 5,
2019
Received:
November 2,
2019
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier B.V. All rights reserved.
