Switching to basal-bolus insulin therapy is effective and safe in long-term type 2 diabetes patients inadequately controlled with other insulin regimens.

Abstract

AIM:

To assess in standard clinical practice the feasibility, efficacy, and safety of switching patients with long-standing type 2 diabetes (T2DM) and poor or unstable blood glucose control to basal-bolus insulin therapy.

MATERIAL AND METHODS:

This was a prospective, single center study including 37 patients with T2DM (age 65±8 years, 62.2% men, body mass index 28.8±6.2 kg/m2, diabetes duration 18±8 years) with poor or unstable glycemic control, who were switched to a basal-bolus insulin regimen with glargine and rapid-acting insulin analogue at the discretion of their physicians. After a group-structured outpatient diabetes training program, patients were followed in a clinical practice setting for 6 months. Clinical and biochemical variables were collected before switching and at 3 and 6 months.

RESULTS:

After switching to basal-bolus therapy, glycosylated hemoglobin (HbA1c) decreased from 9±1.2% to 8.1±1.2% (p<0.001) at 3 months and to 8.0±1.2% at 6 months (p<0.001) without changing total daily insulin dose. The proportion of patients with HbA1c ≥ 9% decreased from 51% to 13.8% at 3 months and to 18.9% at 6 months respectively. There was a single episode of severe hypoglycemia. No changes were seen in body weight and quality of life. The size of LDL (low density lipoprotein) particles significantly increased at 3 and 6 months, while all other lipid parameters remained unchanged.

CONCLUSIONS:

Our study confirmed that basal-bolus insulin therapy is feasible, effective, and safe in patients with long-standing T2DM, and does not impair their quality of life.

• Authors: Irene Vinagre, Juan Sánchez-Hernández, José Luis Sánchez-Quesada, Miguel Ángel María, Alberto de Leiva, Antonio Pérez
• Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion (Endocrinol Nutr) Vol. 60 Issue 5 Pg. 249-53 (May 2013) ISSN: 1579-2021 [Electronic] Spain
• PMID: 23523346 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Chemical References

• Blood Glucose
• Hypoglycemic Agents
• Insulin

Topics

• Aged
• Blood Glucose (analysis)
• Diabetes Mellitus, Type 2 (blood, drug therapy)
• Feasibility Studies
• Female
• Humans
• Hypoglycemic Agents (administration & dosage)
• Insulin (administration & dosage)
• Male
• Prospective Studies
• Time Factors