Clinical implications of overbasalization in patients with diabetes mellitus under basal insulin therapy: a retrospective cohort study
DOI:
https://doi.org/10.30968/jhphs.2026.172.1413Abstract
Objective: To evaluate the prevalence of overbasalization and its association with hypoglycemia and inadequate glycemic control among patients with diabetes mellitus, as well as to assess its repercussions on public health resources. Methods: A retrospective cohort study was carried out at the endocrinology clinic of Hospital Universitário Lauro Wanderley (UFPB), João Pessoa, Brazil. Medical records of adult patients with a diagnosis of diabetes mellitus for ≥12 months, and at least two outpatient visits between December 2022 and June 2023, were included. Data extracted comprised demographic characteristics, diabetes classification, insulin regimen, and hypoglycemic events. Overbasalization was defined as administration of supraphysiological basal insulin doses without achievement of glycemic targets. Statistical analysis assessed the relative risk of hypoglycemia and glycemic control (HbA1c levels) among patients with and without overbasalization. Results: A total of 305 records were screened, of which 112 met the inclusion criteria. Overbasalization was identified in 32 patients (28.6% of the sample). Patients subjected to overbasalization exhibited a 2.38-fold increased relative risk of hypoglycemia (95% CI: 1.13–5.04; p = 0.006) compared to those without overbasalization. Additionally, mean HbA1c was significantly higher in the overbasalization group (10.07% versus 8.47%; p < 0.001), indicating poorer glycemic control. Conclusions: Overbasalization
was found to be highly associated with increased episodes of hypoglycemia and inadequate glycemic control among diabetic patients. This phenomenon not only leads to adverse clinical outcomes—including higher hospitalization rates and diminished quality of life— but also imposes considerable financial strain on the Brazilian Unified Health System (SUS). Implementation of targeted educational strategies and individualized management could mitigate these effects, fostering safer and more effective diabetes care.
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