Hollander PA, et al. - In patients with type 2 diabetes (T2D) during insulin glargine self-titration, researchers assessed risk factors for clinically relevant hypoglycaemia (blood glucose < 3 mmol/L). This investigation draws on data from two clinical trials in which patients were able to improve glycaemic control by self-titration of insulin glargine utilizing a simple algorithm. Post hoc analyses of pooled treatment groups were performed from each of two Phase 3 studies comparing LY2963016 to LANTUS: ELEMENT-2 (double-blind) and ELEMENT-5 (open label). Hypoglycaemia rates were comparable during titration and maintenance periods with the exception of the older subgroup. Self-titration of IGlar did not raise the overall risk of clinically relevant hypoglycaemia in this re-analysis of two Phase 3 studies involving more than 1200 patients with T2D. However, during the titration period, the authors observed older patients at increased risk, and all patients were at increased risk as their HbA1c approached the target value. Individualization of therapy, with special attention to those over the age of 65 and those with better glycaemic control, will be important during titration to avoid hypoglycaemia.