Simple Insulin Dose Adjustment Using 3-3-1 Algorithm in Japanese Patients with Type 2 Diabetes: Start Kanazawa Study (Self-Titration Aggressive Algorithm with Glargine Trial)

Abstract

We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p < 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn't significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose selfadjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.

Relative Contribution of Fasting and Postprandial Blood Glucose in Overall Glycemic Control: Post Hoc Analysis of a Phase IV Randomized Trial

“…This observation suggests that Asian patients may not need much basal insulin to achieve target FBG. In a recently conducted study in Japanese patients, the maximum mean (SD) basal insulin dose needed to achieve significant improvement in HbA1c was 19 (8.5) units (U)/day [ 46 ]. However, in Caucasians, the total daily basal insulin usually needed to achieve target HbA1c was > 40 U/day [ 47 ].…”