Abstract | AIMS: It is of interest to understand how insulin therapy currently evolves in clinical practice, in the years after starting insulin in people with type 2 diabetes. We aimed to describe this evolution prospectively over 4 years, to assist health care planning. METHODS: People who had started any insulin were identified from 12 countries on three continents. Baseline, then yearly follow-up, data were extracted from clinical records over 4 years. RESULTS: Of the 2999 eligible people, 2272 were followed over 4 years. When starting insulin, mean (SD) duration of diabetes was 10.6 (7.8) years, HbA1c 9.5 (2.0)% (80 [22]mmol/mol) and BMI 29.3 (6.3)kg/m(2). Initial insulin therapy was basal 52%, premix 23%, mealtime+basal 14%, mealtime 8% and other 3%; at 4 years, 30%, 25%, 33%, 2% and 5%, respectively, with 5% not on insulin. Insulin dose was 20.2U/day at the start and 45.8U/day at year 4. There were 1258 people (55%) on their original regimen at 4 years, and this percentage differed according to baseline insulin regimen. HbA1c change was -2.0 (2.2)% (-22 [24]mmol/mol) and was similar by final insulin regimen. Hypoglycaemia prevalence was <20% in years 1-4. Body weight change was mostly in year 1, and was very variable, mean +2.7 (7.5)kg at year 4. CONCLUSION: Different insulin regimens were started in people with differing characteristics, and they evolved differently; insulin dose, hypoglycaemia and body weight change were diverse and largely independent of regimen.
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Authors | Philip D Home, Marie-Paule Dain, Nick Freemantle, Ryuzo Kawamori, Martin Pfohl, Sandrine Brette, Valérie Pilorget, Werner A Scherbaum, Giacomo Vespasiani, Maya Vincent, Beverley Balkau |
Journal | Diabetes research and clinical practice
(Diabetes Res Clin Pract)
Vol. 108
Issue 2
Pg. 350-9
(May 2015)
ISSN: 1872-8227 [Electronic] Ireland |
PMID | 25825361
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved. |
Chemical References |
- Blood Glucose
- Glycated Hemoglobin A
- Hypoglycemic Agents
- Insulin
|
Topics |
- Adult
- Aged
- Blood Glucose
(metabolism)
- Body Weight
(drug effects)
- Diabetes Mellitus, Type 2
(blood, drug therapy, epidemiology)
- Drug Administration Schedule
- Female
- Follow-Up Studies
- Glycated Hemoglobin
(analysis)
- Humans
- Hypoglycemia
(blood, chemically induced, epidemiology)
- Hypoglycemic Agents
(administration & dosage, adverse effects)
- Insulin
(administration & dosage, adverse effects)
- Male
- Middle Aged
- Patient Care Planning
(trends)
- Retrospective Studies
- Time Factors
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