Good glycemic control with flexibility in timing of basal insulin supply: a 24-week comparison of insulin glargine given once daily in the morning or at bedtime in combination with morning glimepiride.

The early initiation of insulin therapy to achieve good metabolic control is being increasingly considered in type 2 diabetes (1), but barriers, including fear of hypoglycemia, need to be overcome to achieve target glycemic control (2). Insulin glargine (glargine; Lantus) is a once-daily, basal human insulin analog. The 24-h duration and flat time-action profile of glargine (3) should give flexibility to patients in terms of the injection time despite targeting fasting blood glucose (FBG) close to normal: administration should be possible at any time of day provided it is at the same time each day. Previously, we have demonstrated similar levels of nocturnal hypoglycemia but better glycemic control with morning versus bedtime glargine plus three milligrams glimepiride (4).