Evaluation of insulin regimens as an effective option for glycemic control in patients with type 2 diabetes: A propensity score‐matched cohort study across Japan (JDDM31). Issue 5 (26th February 2014)

• Record Type: Journal Article
• Authors: Kanatsuka, Azuma; Sato, Yasunori; Kawai, Koichi; Hirao, Koichi; Kobayashi, Masashi; Kashiwagi, Atsunori; Japan Diabetes Clinical Data Management Study Group
• Is Part Of: Journal of diabetes investigation. Volume 5:Issue 5(2014:Oct.)
• Page Start: 539
• Page End: 547
• Publication Date: 2014-02-26
• Subjects: Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.12194
• Languages: English
• ISSNs: 2040-1116

Abstract

<abstract abstract-type="main" id="jdi12194-abs-0001"> <title>Abstract</title> <sec id="jdi12194-sec-0001" sec-type="section"> <title>Aims/Introduction</title> <p>We evaluated the long‐term efficacy of insulin regimens in patients with type 2 diabetes mellitus and poor glycemic control despite oral antidiabetic drugs (OAD).</p> </sec> <sec id="jdi12194-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>We carried out a propensity score‐matched cohort study using the CoDiC<sup>®</sup> database of the Japan Diabetes Data Management Study Group across 54 institutions in Japan from 2005 to 2010. A total of 10, 854 patients on OAD in 2005 were studied, and 1, 253 patients (11.5%) were treated with insulin until 2010. The changes in insulin regimens and glycated hemoglobin (HbA1c) levels were analyzed over this study period.</p> </sec> <sec id="jdi12194-sec-0003" sec-type="section"> <title>Results</title> <p>Propensity score matching showed no differences in the baseline patient characteristics. A total of 96 patients transferred to insulin, and HbA1c gradually and significantly decreased in the patients on a twice‐daily premixed preparation of rapid‐acting human‐insulin analogs (twice‐daily MIX) and basal–bolus therapy with rapid‐acting human‐insulin analogs (RA) plus long‐acting insulin analog (LA;<italic> P </italic>< 0.001). A total of 418 patients had insulin added to OAD treatment, and HbA1c decreased in the patients with a twice‐daily MIX (<italic>P </italic>< 0.001), but HbA1c did not differ from the baseline values in the patients on basal LA (<italic>P </italic>= 0.497). The mean decline in HbA1c at the end of the study was therefore larger in the patients receiving twice‐daily MIX than in the patients receiving basal LA (<italic>P </italic>< 0.05).</p> </sec> <sec id="jdi12194-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The present study could suggest the potential loss of opportunity for many patients treated using basal LA to have received alternative insulin regimens and to achieve better glycemic control.</p> </sec> </abstract>