Yes, you can increase your basal insulin glargine from 28 to 30 units now.
A 2-unit increase from 28 to 30 units is appropriate and aligns with the standard evidence-based titration algorithm recommended by the 2025 American Diabetes Association guidelines, which advises increasing basal insulin by 2 units every 3 days to reach your fasting plasma glucose goal without hypoglycemia 1.
Titration Algorithm You Should Follow
The current standard approach is straightforward:
- Increase by 2 units every 3 days until your fasting blood glucose reaches target (typically 80-130 mg/dL or 4.4-7.2 mmol/L) 1
- Continue this pattern as long as you're not experiencing hypoglycemia (blood glucose <70 mg/dL or 3.9 mmol/L)
- Monitor your fasting glucose daily during titration
Important Safety Considerations
Stop and reduce your dose by 10-20% if you experience hypoglycemia without a clear cause (such as missed meals or unusual exercise) 1, 2. This is critical for preventing dangerous low blood sugars.
Check for these warning signs that suggest you might need a different approach rather than just continuing to increase:
- Bedtime-to-morning glucose difference ≥50 mg/dL (2.8 mmol/L) - suggests overbasalization
- Frequent hypoglycemia (aware or unaware)
- High glucose variability throughout the day
- Your fasting glucose improves but A1C remains elevated 1
When to Reassess Your Strategy
If you find yourself needing doses above approximately 0.5-1.0 units/kg/day without achieving your fasting glucose target, this signals overbasalization 3. At that point, continuing to escalate the basal insulin dose becomes counterproductive. Instead, you would need to add mealtime coverage (either a GLP-1 receptor agonist or prandial insulin) rather than pushing basal insulin higher 1.
Practical Execution
- Take your 30 units at the same time every day - consistency matters more than the specific time chosen 2
- Rotate injection sites (abdomen, thigh, or deltoid) to avoid lipodystrophy 2
- Continue this 2-unit increment every 3 days until your fasting glucose consistently hits target
The FDA labeling confirms this approach is safe and effective, with dosage adjustments made under appropriate glucose monitoring 2.