The Correlation Between Fasting Blood Glucose Reduction And Basal Fasting Blood Glucose Level In Hospitalized Patients With Type 2 Diabetes Titrating Insulin Glargine In Fixed Dose

[Background]Patients with type 2 diabetes often use basal-bolus insulin regimen for hypoglycemic therapy during hospitalization.Traditional insulin titrating method is glucose-based"2468 regimen".Our findings,“0.1 regimen”,however,titrating basal insulin dose based on body weight and adjust fixed dose of insulin.Compared with"2468regimen",our weight-based regimen is the same effective and simpler.When FBG close to the target,the same dose insulin do not increase the incidence of hypoglycemia.A lot of studies have shown that for outpatient hypoglycemic therapy in patients with type 2diabetes,the decrease of HbA1c was related to the baseline HbA1c level.So,we hypothesized that in hospitalized patients with type 2 diabetes,hypoglycemic amplitude of fixed dose of insulin are correlated with basal FBG.[Objective]To assess the correlation between fasting blood glucose reduction and basal fasting blood glucose level in hospitalized patients with type 2 diabetes titrating insulin glargine in fixed,weight-based dose.[Methods]This retrospective study collected 215 in-patients with type 2 diabetes.These patients received insulin glargine that was titrated by 0.1 U/kg daily.The research included 567pairs of data about the range of FBG reduction?basal FBG level–followed FBG level?and corresponding basal FBG level?FBG level before increasing insulin glargine dose?.The patients were divided into 50kg group?titrating-dose?5U?,60kg group?titrating-dose6U?and 70kg group?titrating-dose?7U?according to titrating-dose of insulin glargine.The ranges of FBG reduction in each tier were separated into FBG₁₄ interval?basal FBG?14.0 mmol/L?,FBG₁₂ interval?basal FBG 13.9-12.0 mmol/L?,FBG₁₀ interval?basal FBG 11.9-10.0mmol/L?,and FBG₈ interval?basal FBG 9.9-8.1mmol/L?according to basal FBG level.[Results]There were significant positive correlation between the range of FBG reduction and basal FBG level in 50kg group?n=189,rs=0.940,P=0.000?,60kg group?n=165,rs=0.775,P=0.000?and 70kg group?n=213,rs=0.890,P=0.000?.In 50kg group,the ranges of FBG reduction in FBG14 interval,FBG12 interval,FBG10 interval and FBG8 interval were4.2?3.3,5.5?,2.9?0.4,3.8?,1.7?-0.2,3.0?and 0.7?-0.3,1.6?mmol/L,respectively.In 60kg group,they were 5.8?3.1,9.5?,3.0?-0.5,4.9?,1.7?-0.3,3.0?and 1.0?-0.5,2.0?mmol/L,respectively.And in 70kg group they were 6.0?2.7,18.3?,3.4?2.4,4.4?,1.9?-0.4,3.3?and0.8?-0.1,1.9?mmol/L,respectively.The ranges of FBG reduction in each group showed a significant difference among four intervals.[Conclusion]When titrating insulin in fixed dose FBG reduced amplitude is correlated with basal FBG level.