Dr. Om J Lakhani introduces the concept of Basal-plus insulin therapy
00:02 🩺 Introduction to Basal-plus insulin therapy
Basal insulin is often the initial choice for type 2 diabetes management, focusing on controlling fasting blood sugar levels.
Despite achieving fasting sugar control, some patients struggle to reach target HbA1c levels.
Basal-plus insulin therapy involves adding short-acting insulin before the largest meal of the day to address postprandial glucose spikes.
01:20 💊 Treatment options for uncontrolled postprandial sugar
Options include using oral anti-diabetic drugs targeting postprandial sugar, such as AGIs, short-acting sulfonylureas, or DPP4 inhibitors.
Switching to premixed insulin is another option but can be more complex.
Basil-plus therapy, adding short-acting insulin to basal insulin, is often the preferred choice without changing the basal insulin regimen.
02:17 🔄 The domino effect and its impact on glycemic control
The domino effect refers to correcting one postprandial surge leading to improved glycemic control throughout the day.
Starting basal-plus therapy before the largest meal of the day can effectively flatten post-meal glucose spikes.
Identifying the major meal can vary among patients; starting therapy before the first meal helps correct subsequent postprandial surges.
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