Titrating beyond glycemic goal: "post-glycemic target phenomenon".

Corresponding Author: Allen B. King, M.D., C.D.E., Diabetes Care Center, 1260 S. Main, Salinas, CA 93901; email address [email protected] In clinical trials in which once-daily basal insulin is titrated to fasting plasma glucose (FPG) targets, the goal is usually reached before the end of the study. After reaching the goal but before the end of the study and if the titration is continued, the mean dosage rises, but without a change in the mean FPG.1 We had the opportunity to observe this “post-glycemic goal phenomenon” in a group of subjects with uncontrolled type 2 diabetes titrated with once-nightly insulin determir.