Abstract
The rate limiting step of intensive diabetes management for patients with diabetes is treatment induced hypoglycemia. Thus, hypoglycemia remains a significant barrier in optimizing glycemic control and reducing long-term diabetes related complications including cardiovascular death, stroke, and all cause-mortality [1]. Cardiovascular (CV) events are the leading cause of death among patients with diabetes. The risk of CV death is twice that of patients without diabetes [2]. Severe hypoglycemia (resulting in cognitive impairment) can occur across a broad spectrum of A1C levels. Patients achieving near-normal glycemia
Highlights
The rate limiting step of intensive diabetes management for patients with diabetes is treatment induced hypoglycemia
Degludec appears to have the lowest coefficient of variability of all insulins, allowing ambitious dosing to targeted fasting glucose levels, with less likelihood of nocturnal and overall hypoglycemia compared with insulin glargine [22]
Each 32-week interval consisted of a 32-week titration period which allowed patients to achieve their glycemic targets, followed by a 16-week maintenance phase comparing the difference in hypoglycemia events when glycemic control and doses were stable
Summary
The rate limiting step of intensive diabetes management for patients with diabetes is treatment induced hypoglycemia. She is advised to increase the dose by 1 unit each night until her fasting blood glucose level is
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