TABLE 1.
Titration Algorithms Evaluated in Clinical Trials
| Trial | Study Group | Comparison Group |
|---|---|---|
| Treat-to-target (50) | Algorithm 1: Gla-100 titration | Algorithm 2: NPH titration |
| Increase Gla-100 dose by: | Increase NPH dose by: | |
| • 8 units with FPG ≥180 mg/dL | • 8 units with FPG ≥180 mg/dL | |
| • 6 units with FPG 140–180 mg/dL | • 6 units with FPG 140–180 mg/dL | |
| • 4 units with FPG 120–140 mg/dL | • 4 units with FPG 120–140 mg/dL | |
| • 2 units with FPG ≥100–120 mg/dL | • 2 units with FPG ≥100–120 mg/dL | |
| ATLANTUS study (43) | Algorithm 1: Patient self-titration | Algorithm 2: Physician titration |
| Increase Gla-100 dose by: | Increase Gla-100 dose by: | |
| • 6–8 units with FPG ≥180 mg/dL | • 2 units with FPG ≥180 mg/dL | |
| • 4 units with FPG 140–180 mg/dL | • 2 units with FPG 140–180 mg/dL | |
| • 2 units with FPG 120–140 mg/dL | • 2 units with FPG 120–140 mg/dL | |
| • 0–2 units with FPG ≥100–120 mg/dL | • 0–2 units with FPG ≥100–120 mg/dL | |
| PREDICTIVE study (44) | Patient self-titration | Standard care |
| • Decrease insulin detemir by 3 units with mean FPG <80 mg/dL | ||
| • Keep insulin detemir dose the same with mean FPG 80–100 mg/dL | ||
| • Increase insulin detemir dose by 3 units with FPG >110 mg/dL | ||
| INSIGHT trial (45) | Patient self-titration |
EDITION algorithm |
| • Increase Gla-300 dose by 1 unit/day if FPG >100 mg/dL | • Increase Gla-300 dose by: | |
| 3 units if SMPG value >100 and <140 mg/dL | ||
| 6 units if SMPG value ≥140 mg/dL | ||
| • Decrease by 3 units if SMPG value <79 mg/dL |
SMPG, self-monitoring of plasma glucose.