Clinical Considerations for Basal Insulin
In this video, PA Orr shares the two questions she asks when a patient needs therapy escalation: whether basal insulin is appropriate, and if so, whether weekly or daily dosing fits best. She reviews the clinical factors she weighs, including pregnancy, drug interactions, and hypoglycemia risk.
She also covers glucose monitoring, including the benefits of CGM, and who may be a better fit for weekly versus daily insulin. PA Orr touches on insurance and access, and on the considerations when switching a patient from daily to weekly insulin.
Key Takeaways:
- Weekly basal insulins are indicated for adults with type 2 diabetes.
- When initiating basal insulins, be aware of concomitant medications that can increase the risk of hypoglycemia.
- Recommend continuous glucose monitoring for your patients with type 2 diabetes.
Speaker
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References and Additional Resources:
American Diabetes Association Professional Practice Committee for Diabetes; 7. Diabetes Technology: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49 (suppl1): S150–S165. https://diabetesjournals.org/care/article/49/Supplement_1/S150/163922/7-Diabetes-Technology-Standards-of-Care-in
AWIQLI. Prescribing Information. Novo Nordisk, Inc.; 2026. https://www.novo-pi.com/awiqli.pdf
Mehta R, Goldenberg R, Katselnik D, Kuritzky L. Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care. Ann Med. 2021;53(1):998-1009. https://pmc.ncbi.nlm.nih.gov/articles/PMC8231382/
ONSWIK. Prescribing Information. Eli Lilly and Company. 2026. https://uspl.lilly.com/onswik/onswik.html#pi
Seufert J, Mehta S, Rahman S, et al. Association of continuous glucose monitoring on all-cause mortality and macrovascular complications in adults with type 2 diabetes on basal insulin therapy in the U.S.: a target trial emulation. Presented at: 62nd EASD Annual Meeting; September 28 – October 2, 2026; Milan, Italy. Abstract LBA 21. https://easddistribute.m-anage.com/from.storage?image=DRQMKAdip9FzW2MCANbX49bg52ETgGDBP3rBJxWghd8d_WZX5fOp53SRpSvJ4gKN0
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