Cowart and Carris recently wrote a commentary in Clinical Diabetes (1) defending their definition of overbasalization as occurring in patients with A1C levels >8.0% who are receiving >0.5 units/kg of a basal insulin. Their commentary was written in response to an earlier commentary by me that was also published in this journal (2), in which I challenged their definition, although they did not mention my earlier article in theirs. I had made the case that the appropriate definition of overbasalization is a clinical situation in which basal insulin doses are increased even further after fasting plasma glucose (FPG) targets have been achieved in an attempt to control postprandial glycemia during the day (2). This practice often results in hypoglycemia, usually overnight. Cowart and Carris agreed with that definition describing overbasalization but stated that it was uncommon (not in my experience) and went on to...

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