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Observational Registry of Basal Insulin Treatment (ORBIT) in patients with type 2 diabetes uncontrolled with oral antihyperglycaemic drugs: Real-life use of basal insulin in China
- Source :
- Diabetes, Obesity and Metabolism. 19:822-830
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- To examine treatment patterns following basal insulin (BI) introduction in type 2 diabetes mellitus (T2DM) patients under real-world conditions across China.Overall, 18 995 patients inadequately controlled (HbA1c ≥ 53 mmol/mol [7%]) with oral antihyperglycaemic drugs (OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3). Type of BI was initiated at physicians' discretion.Retention with BI therapy at 6 months was 75.6%. Use of long-acting BI predominated, with insulin glargine accounting for 71%, detemir 13% and Neutral Protamine Hagedorn (NPH) insulin 16%. Over 70% of long-acting users maintained the same initial BI at visit 3, while 40% of NPH users switched treatment and 24.4% of participants initiated BI with prandial insulin. The initial mean (± SD) dose of BI and total insulin was 0.18 ± 0.07 and 0.25 ± 0.19 IU/kg, respectively, with a mean increase of daily dose by 0.03 and 0.02 IU/kg after 6 months, respectively. Only 56.6% of insulin users reported dose titration at visit 3. Mean HbA1c was 81 mmol/mol (9.6%) at baseline and 57 mmol/mol (7.4%) at 6 months. The frequency of hypoglycaemia was 1.61 and 2.07 episodes/patient-year at baseline and 6 months, respectively.In real-world clinical settings, add-on BI therapy in T2DM patients is associated with significant improvement in glycaemic control without overtly compromising safety related to hypoglycaemia and weight gain. Evolution of insulin treatment regimens varied among patients, but dose titration was suboptimal. More active BI dose titration might further improve glycaemic outcome in patients receiving BI therapy.A free Video Abstract to accompany this article is available at https://vimeo.com/212655959.
- Subjects :
- Blood Glucose
Male
China
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Type 2 diabetes
030204 cardiovascular system & hematology
Hypoglycemia
03 medical and health sciences
0302 clinical medicine
Endocrinology
Internal medicine
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Registries
Aged
Glycated Hemoglobin
business.industry
Insulin glargine
Insulin
Basal insulin
Type 2 Diabetes Mellitus
Middle Aged
medicine.disease
Surgery
Insulin, Long-Acting
Treatment Outcome
Diabetes Mellitus, Type 2
Drug Therapy, Combination
Female
Observational study
medicine.symptom
business
Weight gain
medicine.drug
Subjects
Details
- ISSN :
- 14628902
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Diabetes, Obesity and Metabolism
- Accession number :
- edsair.doi.dedup.....0d2ae8305da42f00b2300e342525657b