Overbasalization

Question 1

What is a key indicator of insulin overbasalization related to blood glucose levels?

Answer 1

Frequent hypoglycemia, especially nocturnal or between-meal hypoglycemia

Blood glucose <70 mg/dL during fasting or overnight

Question 2

What weight change is associated with insulin overbasalization?

Answer 2

Unexplained weight gain

Weight increase without changes in diet or activity

Question 3

What does high postprandial glucose indicate in relation to basal insulin?

Answer 3

Elevated blood sugar after meals, despite adequate basal insulin

Example: Post-meal spikes but normal/low fasting glucose

Question 4

What is considered an excessive basal insulin dose?

Answer 4

Basal insulin >0.5 units/kg/day

Example: >35 units/day for a 70 kg patient with poor glycemic control

Question 5

What phenomenon is mismanaged leading to early morning hyperglycemia?

Answer 5

Dawn phenomenon mismanagement

Incorrectly attributed to low basal insulin, leading to dose increases

Question 6

What is the significance of a hemoglobin A value less than 8.5% (<69 mmol/mol)?
More related for FBG OR PPBG?

Answer 6

The largest contributor to the elevated hemoglobin A is postprandial hyperglycemia

Question 7

Fill in the blank: A blood glucose level drop by more than ______ mg/dL during the night is a key indicator of insulin overbasalization.

Answer 7

100

Question 8

True or False: Higher doses of basal insulin are associated with improved glycemic control.

Answer 8

False

Higher doses have been associated with an increased risk of hypoglycemia and weight gain, but not much further improvement in glycemic control