ArticleJournal of diabetes investigation2026
An aggressive insulin titration pattern is associated with better glycemic control during short-term intensive insulin therapy.
Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo investigate the associations between insulin titration patterns and glycemic outcomes in continuous subcutaneous insulin infusion (CSII)-based short-term intensive insulin therapy (IIT). MATERIALS AND
methodsMedical records of newly diagnosed type 2 diabetes (2001-2022) were stratified by time to achieve maximum dose (T
resultsA total of 1,916 patients were stratified into ascending (n = 514) or descending (n = 1,402) groups, and aggressive (n = 681) or non-aggressive (n = 721) cohorts. dTIR was highest in the aggressive group, followed by the non-aggressive and ascending groups (89.7% [84.5, 93.6], 85.7% [79.6, 90.8], 76.2% [64.3, 84.9], respectively). Compared with the non-aggressive group, the aggressive group had a 1.73-percentage-point higher dTIR after adjustment (95% CI 0.91-2.56; P < 0.001), lower glucose variability, lower maximum and pump-suspension insulin doses, greater dose reduction, and shorter CSII treatment and hospitalization, with similar dTBR1 and post-therapy FG (6.1 ± 1.2 vs. 6.3 ± 1.2 mmol/L, P = 0.056). Predictors of post-therapy FG <6.1 mmol/L included higher BMI, greater dTIR and dTBR1 in both trajectory groups; younger age, lower HbA1c, longer CSII duration, and lower final insulin dose in the descending group.
conclusionsAn aggressive titration pattern was associated with better glycemic control without increasing detected hypoglycemia relative to the non-aggressive pattern, suggesting a potential benefit of timely insulin titration that requires prospective evaluation.
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