Insulin Glargine Dosing Every 16 Hours for a Complicated Type I Diabetes Case

Abstract

ABSTRACT Objective: Type I diabetes mellitus (T1DM) is the most common type of diabetes during childhood. Insulin therapy is the mainstay of T1DM treatment, and glargine is long-acting insulin that is most commonly prescribed as a basal insulin therapy. Although glargine is typically administered once daily in the evening, alternative dosing frequencies and timings have been associated with promising results. Methods: A 23-year-old woman with a 16-year history of T1DM who was initially started on regular and neutral protamine Hagedorn insulin continued to have a poorly controlled glycated hemoglobin (HbA1c) level of 9.8% (84 mmol/mol). She was switched to glargine and glulisine, and her HbA1c improved to 8.5% (69 mmol/mol) with frequent high blood glucose readings at 12 PM. Her case was later complicated with gastroparesis and she was switched to an insulin pump. However, she suffered from two unexplained diabetic ketoacidosis episodes and opted to discontinue the pump therapy. Next, she was switched back...