To compare insulin doses in patients treated with insulin glargine or insulin detemir, Wallace et al conducted an analysis that included

• 5 large randomized controlled trials in patients with type 2 diabetes, and
• 2 large randomized controlled trials in patients with type 1 diabetes.1

To achieve similar glycemic control, patients treated with insulin detemir required on average a 38% higher dose of insulin compared with patients treated with insulin glargine (Analysis of Doses in Patients Treated With Insulin Glargine or Insulin Detemir in Randomized Controlled Trials).1

Dailey et al conducted a pooled analysis of 22 randomized clinical trials in patients with type 2 diabetes to compare insulin doses in patients treated with insulin glargine or insulin detemir. To achieve a similar reduction in glycated hemoglobin (HbA1c) levels, patients treated with insulin detemir required a 31% higher mean insulin dose compared with patients treated with insulin glargine (Analysis of Doses in Patients Treated With Insulin Glargine or Insulin Detemir in Randomized Controlled Trials).2

Wallace et al concluded that since higher doses of insulin detemir may be needed to obtain similar glycemic control, prescribers may consider a dosage reduction when transitioning from insulin detemir to insulin glargine in order to reduce the risk of hypoglycemia that may result when using a unit-to-unit conversion.1

If transitioning from a treatment regimen with an intermediate- or long-acting insulin to a regimen with Basaglar, a change in the dose of the basal insulin may be required.3

Patients may be predisposed to hypoglycemia or hyperglycemia by changes in insulin

• strength
• manufacturer
• type
• injection site, or
• method of administration.3

Insulin treatment changes should be made

• under close medical supervision, and
• with increased frequency of blood glucose monitoring.3

In patients with type 2 diabetes, dosage adjustments of concomitant antihyperglycemic medications may be needed.3