ReviewDiabetic medicine : a journal of the British Diabetic Association2013
Stepwise intensification of insulin therapy in type 2 diabetes management--exploring the concept of the basal-plus approach in clinical practice.
Review in Diabetic medicine : a journal of the British Diabetic Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 45 citations in OpenAlex.
- Effect of prandial treatment timing adjustment, based on continuous glucose monitoring, in patients with type 2 diabetes uncontrolled with once-daily basal insulin: A randomized, phase IV study.Diabetes, obesity & metabolism · 2018Trial
- Adding fast-acting insulin aspart to basal insulin significantly improved glycaemic control in patients with type 2 diabetes: A randomized, 18-week, open-label, phase 3 trial (onset 3).Diabetes, obesity & metabolism · 2017Trial
- Treatment intensification with an insulin degludec (IDeg)/insulin aspart (IAsp) co-formulation twice daily compared with basal IDeg and prandial IAsp in type 2 diabetes: a randomized, controlled phase III trial.Diabetes, obesity & metabolism · 2016Trial
- From guidelines to practice: an Egyptian expert opinion on type 2 diabetes mellitus management in primary care settings.BMC primary care · 2025Article
- A Difference Between Bedtime and Pre-Breakfast Plasma Glucose Levels Indicates the Need for Prandial Insulin in Basal Insulin-Treated Type 2 Diabetic Patients with Normal Fasting Glucose.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- A higher blood glucose level pre-breakfast in comparison to bedtime is a contraindication for intensification of prandial insulin therapy in patients with type 2 diabetes - The impact of a negative BeAM value.Journal of clinical & translational endocrinology · 2018Article
- A 32-Week Randomized Comparison of Stepwise Insulin Intensification of Biphasic Insulin Aspart (BIAsp 30) Versus Basal-Bolus Therapy in Insulin-Naïve Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018Article
- Initiation and Intensification Strategies in Type 2 Diabetes Management: A Comparison of Basal Plus and Premix Regimens.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2016Review
- Association between insulin dosage and insulin usage time, and coronary artery lesions in patients with type 2 diabetes and coronary heart disease.Experimental and therapeutic medicine · 2016Article
- Recombinant Human Insulins - Clinical Efficacy and Safety in Diabetes Therapy.European endocrinology · 2016Review
- Insulin lispro low mixture twice daily vs basal insulin glargine once daily and prandial insulin lispro once daily as insulin intensification strategies in patients with type 2 diabetes: Latin American subpopulation analysis of a randomized trial.Diabetology & metabolic syndrome · 2016Article
- Use of V-GoDiabetes therapy : research, treatment and education of diabetes and related disorders · 2015Article
- Management of Type 2 Diabetes - Methods for Addition of Prandial to Basal Insulin.European endocrinology · 2014Review
- Beneficial effects of parenteral GLP-1 delivery by cell therapy in insulin-deficient streptozotocin diabetic mice.Gene therapy · 2013Article
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Basal insulin provides an effective method for initiating insulin therapy in people with Type 2 diabetes, resulting in significant improvements in glycaemic control, lower rates of hypoglycaemia and less weight gain than either prandial or premixed insulin regimens. However, the progressive nature of Type 2 diabetes and the inability of basal insulin to correct excessive postprandial glucose excursions mean that insulin therapy will eventually need to be intensified, typically by adding prandial insulin as part of a basal-bolus or premixed insulin regimen. The aim of this review is to summarize recent clinical evidence for a staged 'basal-plus' strategy for insulin intensification where one, two or three prandial insulin injections are added to basal insulin according to individual need. In the early stages of insulin therapy, most individuals seem to achieve favourable glycaemic control with basal insulin alone, or in combination with a single prandial insulin injection. The addition of a single prandial insulin injection at the largest meal is well tolerated and associated with significant improvements in glycated haemoglobin (HbA(1c)), low rates of hypoglycaemia and limited weight gain. More people achieve recommended HbA(1c) targets with a basal-plus strategy, compared with twice-daily premixed insulin therapy, with lower rates of hypoglycaemia. The data indicate that a step-by-step approach with the basal-plus strategy is a promising alternative method of insulin intensification that allows for individualization of treatment and may delay progression to a full basal-bolus insulin replacement therapy for many individuals.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.