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Glycaemic control and hypoglycaemia burden in patients with type 2 diabetes initiating basal insulin in Europe and the USA.pdf (889.74 kB)
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Glycaemic control and hypoglycaemia burden in patients with type 2 diabetes initiating basal insulin in Europe and the USA.

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conference contribution
posted on 2018-05-30, 12:36 authored by Dídac Mauricio, Luigi Meneghini, Jochen Seufert, LLaura Liao, Hongwei Wang, Liyue Tong, Anna Cali, Peter Stella, Paulo Carita, Kamlesh Khunti
AIMS: To evaluate short- and long-term glycaemic control and hypoglycaemia incidence in insulin-naïve patients ≥30 years of age with type 2 diabetes (T2DM) initiating basal insulin (BI) with or without oral anti-hyperglycaemic drugs (OADs). METHODS: This was an observational, retrospective longitudinal analysis of electronic medical records from 5 European countries and the USA. A multivariable logistic regression model assessed baseline and short-term (0-3 months post BI initiation) factors associated with long-term (3-24 months) glycaemic control and hypoglycaemia. RESULTS: Overall, 40 627 patients were included; 20.9% and 27.8% achieved the general HbA1c target of ≤7% at 3 and 24 months post BI initiation, respectively. Failure to achieve HbA1c ≤7% at 3 months was associated with increased risk of failing to achieve target at 24 months (odds ratio [OR], 3.70 [95% CI, 3.41-4.00]). Over 24 months, 8.9% of patients experienced a recorded hypoglycaemic event. Hypoglycaemia during the initial 3-month period was associated with longer-term risk of these events over the ensuing 3 to 24 months (OR, 5.71 [95% CI, 4.67-6.99]). CONCLUSIONS: Initiating BI with or without OADs is associated with short- and long-term suboptimal glycaemic control; the majority of patients fail to achieve HbA1c target ≤7% in the first 3 months, or after 2 years of BI treatment. Treatment response and hypoglycaemia incidence by 3 months post BI initiation are associated with longer-term glycaemic control and hypoglycaemic risk, respectively. These results support the need for early anti-hyperglycaemic interventions that more effectively control blood glucose levels without increasing the risk of hypoglycaemia.


The authors received editorial support for preparation of this manuscript from Julianna Solomons and Leanne Regan of Fishawack Communications, funded by Sanofi. K. K. acknowledges support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – East Midlands (NIHR CLAHRC – EM) and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit.



Diabetes, Obesity and Metabolism, 2017, 19 (8), pp. 1155-1164

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Additional Supporting Information may be found online in the supporting information tab for this article. Aspects of this study were previously presented as a poster presentation at the 51st Annual Meeting of the European Association for the Study of Diabetes, September 14 to 18, 2015, Stockholm, Sweden and at the IDF World Diabetes Congress, November 30 to December 4, 2015, Vancouver, Canada.



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