Glycaemic control and hypoglycaemia burden in patients with type 2 diabetes initiating basal insulin in Europe and the USA
Por:
Mauricio, D, Meneghini, L, Seufert, J, Liao, L, Wang, HW, Tong, LY, Cali, A, Stella, P, Carita, P and Khunti, K
Publicada:
1 ago 2017
Resumen:
Aims: To evaluate short-and long-term glycaemic control and hypoglycaemia incidence in insulin-naive 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.
Filiaciones:
:
Hosp Badalona Germans Trias & Pujol, CIBERDEM, Dept Endocrinol & Nutr, Badalona, Spain
Meneghini, L:
Univ Texas Southwestern Med Ctr Dallas, Div Endocrinol, Dallas, TX 75390 USA
Parkland Hlth & Hosp Syst, Dallas, TX USA
Seufert, J:
Univ Freiburg, Med Ctr, Fac Med, Div Endocrinol & Diabetol,Dept Med 2, Freiburg, Germany
Liao, L:
Sanofi, Bridgewater, NJ USA
Wang, HW:
Sanofi, Bridgewater, NJ USA
Tong, LY:
Sanofi, Bridgewater, NJ USA
Cali, A:
Sanofi, Paris, France
Stella, P:
Sanofi, Paris, France
Carita, P:
Sanofi, Paris, France
Khunti, K:
Univ Leicester, Diabet Res Ctr, Leicester, Leics, England
Green Published, hybrid
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