Oxygen treatment for pneumothorax should be viewed as a prescribed drug, with documentation for its indication, target saturation and titration goals.
The failure to reach titration goals in the majority of both treatment groups, along with the lower doses of insulin, has the potential to mask any advantages of glargine treatment with regard to the avoidance of hypoglycemia and perceived benefits from a patient perspective.
Figure 2 presents guidance for physicians on changing from basal insulin to a premix insulin analog including titration to goal.
Self-measured, plasma-referenced fasting capillary blood glucose tests were done at least twice-weekly to guide titration, with the goal of achieving and maintaining fasting glucose at ≤5.3 mmol/L (≤95 mg/dL).
The primary goal of titration throughout the 24-week RCT period will be the absolute avoidance of all glucose levels <4 mmol/l as determined by CGM and SMBG.
After prolonged use, there is a leftward shift in the dose-response curve such that, without regular titration against a therapeutic goal, there is a risk of excessive iNO administration, associated with toxicity and loss of the therapeutic effect [ 3].
After prolonged use, there is a leftward shift in the dose-response curve such that, without regular titration against a therapeutic goal, there is a risk of excessive iNO administration that is associated with toxicity and loss of the therapeutic effect [ 31].
Only a fraction of trials reported the attainment of LDL goals, despite titration studies having stated in the methods that doses could be doubled to achieve these targets.
Because insulin titrations are guided by goal attainment with each treatment, treat-to-target trials enable clinicians to determine differences in non-glycaemic treatment effects, such as rates of hypoglycaemia and weight gain, at the same level of glycaemic control.
Further studies have shown that patients can successfully manage goal-directed titration of insulin detemir themselves using simple algorithms such as the '303' approach, 77, 97, 109 in which the dose is adjusted by −3, 0 or +3 units every three days, depending on the mean value of the previous three fasting plasma glucose (FPG) readings and/or occurrence of hypoglycemia.
Failing oral antidiabetes therapy, an additional injectable treatment option comprises either the start of an insulin therapy (often basal insulin as the first step of insulin treatment) with dose titration to the individual glycemic goal or the injection of a GLP-1 RA as incretin-based therapy.
