Question

A 50-year-old with T2D and A1c 9.4% on metformin and GLP‑1 RA has fasting hypoglycemia when basal insulin was added recently at 0.6 U/kg. Best adjustment?

Accepted Answer

Reduce basal insulin toward ~0.1-0.2 U/kg and titrate based on fasting glucose while continuing noninsulin agents

Answer

Increase basal insulin to overcome highs

Answer

Stop GLP‑1 RA when adding insulin routinely

Answer

Add prandial insulin in place of basal

Answer

No change; hypoglycemia will abate

Practice question

A 50-year-old with T2D and A1c 9.4% on metformin and GLP‑1 RA has fasting hypoglycemia when basal insulin was added recently at 0.6 U/kg. Best adjustment?