. 2018 Mar 5;9(2):449–492. doi: 10.1007/s13300-018-0384-6

Table 5.

Initiation of basal therapy

Modified from [17]

	Glucose value	Total daily dose
Step 1: initiation with basal insulin^a	HbA1c < 8% (< 64 mmol/mol)	0.1–0.2 units/kg
Step 1: initiation with basal insulin^a	HbA1c > 8% (> 64 mmol/mol)	0.2–0.3 units/kg
Step 2: titration^b (every 2–3 days to reach glycemic goals)	Fixed regimen	Increase by 2 units/day
	Adjustable regimen
	FPG > 10 mmol/L	Add 4 units
	FPG 7.77–10 mmol/L	Add 2 units
	FPG 6.11–7.72 mmol/L	Add 1 unit
Step 3: monitor for hypoglycemia	BG < 3.88 mmol/L	Reduce by 10–20%
Step 3: monitor for hypoglycemia	BG < 2.22 mmol/L	Reduce by 20–40%

HbA1c glycated hemoglobin A1c, BG blood glucose, FPG fasting plasma glucose, NPH neutral protamine Hagedorn, SU sulfonylureas

^aConsider discontinuing SU therapy and basal analogues should be preferred over NPH insulin

^bFor most patients with T2DM taking insulin, glucose goals are HbA1c < 7% (< 53 mmol/mol) and fasting and premeal blood glucose < 6.11 mmol/L in the absence of hypoglycemia. HbA1c and FPG targets may be adjusted on the basis of patients age, duration of diabetes, presence of comorbidities, diabetic complications, and hypoglycemia risk