Ace the Case: A 70-Year-Old Woman With a 25-Year History of Type 2 Diabetes Mellitus and an Elevated A1C


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Question 1
In patients with T2DM, the basal insulin dose should be optimally titrated using an evidence-based titration algorithm to achieve which of the following goals?
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Correct answer: A

Rationale: PA standard approach for optimizing basal insulin regimens is to titrate the dose based on a target fasting glucose concentration. A patient's fasting glucose target should be customized based on the patient's individual characteristics, comorbidities, and risk of hypoglycemia. Long-acting insulin analogs (including degludec [U100 or U200], glargine [U100 and U300], and detemir) have been shown to be effective for controlling fasting glucose and reducing the risk of hypoglycemia, particularly overnight, when titrated to the same fasting glucose target as NPH insulin.18-22