Overbasalization Overload: Navigating Next Steps in Diabetes Care

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: Overbasalization is a concern in patients with type 2 diabetes (T2DM) once a patient's basal dose exceeds 0.5 units/kg/day. The risks associated with overbasalization have not been well documented, but some research has linked an increased association with cardiovascular risks, improper glycemic control resulting in additional weight gain, and higher rates of hypoglycemia. Currently, there is no clear guidance on which regimen provides optimal care once patients have reached this threshold. The purpose of this study is to characterize the various pharmacologic treatment intensification strategies in patients with T2DM who have surpassed 0.5 units/kg/day of basal insulin. Methods: This IRB-approved study is a descriptive, retrospective, cross-sectional study. It is designed to characterize antidiabetic regimens in patients ≥ 18 years old with T2DM receiving basal insulin at doses greater than 0.5 units/kg/day and remain uncontrolled (HbA1c > 8%). Patients must have at least 1 subsequent office visit within one year at Henry Ford Health outpatient clinics between August 2020 - August 2024. Patients will be excluded if they are managed by endocrinologists or ambulatory care pharmacists, received bolus insulin prior to reaching 0.5 units/kg/day, patients with type 1 diabetes mellitus and vulnerable populations. The primary outcome is to classify the proportion of patients using different pharmacological treatment intensification strategies. Secondary outcomes include the change in HbA1c, change in weight, change in basal insulin dose and frequency of HbA1c targets achieved, medication adverse events, and hypoglycemic events. Data will be collected from electronic health records at baseline, and with each subsequent office visit for up to one year. Descriptive statistics and Mann Whitney U test will be used to analyse the data.

Volume

82

First Page

S1287

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