Practical Implementation of ADA/EASD Consensus Algorithm in Patients with Type 2 Diabetes: Timely Insulin Initiation and Titration
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- Category: Vol. 85, September 2017
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Practical Implementation of ADA/EASD Consensus Algorithm in Patients with Type 2 Diabetes: Timely Insulin Initiation and Titration, EBTISSAM ZAKARIA, MANAL ABU SHADY and MOHAMED SALLAM
Abstract
Background: The global burden of diabetes mellitus type 2 is increasing continuously. This is most observed in devel-oping countries due to the higher obesity rate and unhealthy lifestyle. The adherence of physicians and their patients to specific guidelines is thought to improve the treatment out-comes.
Subjects and Methods: This national, multicentre, pro-spective, observational study was conducted in Egypt. Uncon-trolled type 2 diabetic patients (either insulin naïve patients who initiated insulin glargine therapy based on physician discretion or insulinized patients receiving a single daily injection of any basal insulin) were assessed for demographics, diabetes history and previously used anti-diabetic medications, diabetes education, concomitant diseases, patient empowerment and HbA1c. In addition, changes in HbA1c and FBG values and HbA1c target (<7%) achievement after 3 and 6 months of suing insulin glargine containing regimen were assessed.
Results: A total of 1563 patients were eligible for efficacy analysis. The percentage of patients achieving the HbA1c target after 3 months of treatment was 15.4% (95% CI: 13.6- 17.1) but this percentage was higher after 6 months of treatment (42.2%; 95% CI: 39.7-44.6%). Mean value of HbA1c at baseline 8.9% was significantly reduced (p<0.001) to reach 7.2% after 6 months of treatment. Mean FBG value after 6 months of treatment (128.8mg/dl) was significantly (p<0.001) lower than baseline value (198.2mg/dl). There was a statisti-cally significant increase (p<0.001) in the mean prescribed daily dose of insulin glargine form baseline visit (13.6U/day) to end of treatment duration (19.5U/day). Safety of the Insulin glargine containing regimen was assessed by number of patients who have reported hypoglycemic episodes during the study duration which was 24 (1.3%) patients.
Conclusion: Treatment of type 2 diabetic patients with insulin glargine based regimen, following ADA/EASD Con-sensus Algorithm, for 6 months has resulted in a significant reduction in the mean value of HbA1c and FBG compared to baseline. Hypoglycemic events were reported in only 1.3% of patients.