Titration Investigation: Basal Insulin and Fixed-Ratio Combination Protocols

Titration is a crucial element for individuals with diabetes taking basal insulin to achieve their glycemic targets, so how do we ensure we’re doing it optimally?

Our host, Dr. Ronald Goldberg, takes a deeper look into this topic with Dr. Irene Hramiak, a Professor of Medicine at Western University, and the current Department of Medicine Site Chief and Endocrinologist at St. Joseph’s Hospital.

This episode discusses the history of basal insulin titration and how standard protocols have changed over time, with new advances brought on by clinical evidence from trials like the INSIGHT study, and patient empowerment. Our experts also take a deeper look into the recent LixiLan ONE CAN study, of which Dr. Hramiak was the primary investigator: Comparing a daily versus weekly titration algorithm in people with type 2 diabetes switching from basal insulin to iGlarLixi in the LixiLan ONE CAN randomized trial.

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The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Goldenberg:

Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi.

Dr. Hramiak:

Membership on advisory boards or speaker’s bureau including receipt of honoraria: CCRN, Canadian Medical & Surgical Knowledge Translation Research Group, Boehringer Ingelheim/Eli Lilly (BI-LILLY joint venture), Eli Lily & Co, Insulet Corp, Medtronic, Merck & Co Inc, Novo Nordisk, Sanofi-Aventis, Western University. Membership on advisory boards or speaker’s bureau: CCRN, Canadian Medical & Surgical Knowledge Translation Research Group, Boehringer Ingelheim/Eli Lilly (BI-LILLY joint venture), Eli Lily & Co, Insulet Corp, Medtronic, Merck & Co Inc, Novo Nordisk, Sanofi-Aventis. Funded grants, research or clinical trials: Eli Lilly, Novo Nordisk, Sanofi.