In a prospective controlled trial the effects of a 5-day in-patient treatment and teaching programme for Type 1 (insulin-dependent) diabetes mellitus on metabolic control and health care costs were studied in Moscow. Two different intervention programmes were compared, one based upon urine glucose self-monitoring (UGSM, n = 61) and one using blood glucose self-monitoring (BGSM, n = 60). Follow-up was 2 years. A control group (n = 60) continued the standard treatment of the Moscow diabetes centre and was followed-up for 1 year. Costs and benefits with respect to hospitalizations and lost productivity (according to average wage) were measured in November 1992 rubles (Rb.), with respect to imported drugs and test strips in 1992 German marks (DM). In the intervention groups there were significant decreases of HbA1 values [UGSM: 12.5% before, 9.4% after 1 year, 9.2% after 2 years (p < 0.0001); BGSM: 12.6% before, 9.3% after 1 year, 9.2% after 2 years (p < 0.0001) compared to no change in the control group (12.2% before, 12.3% after 1 year)], and of the frequency of ketoacidosis. The frequency of severe hypoglycaemia was comparable between the UGSM (10 cases during 2 years), BGSM (10 cases during 2 years), and the control group (8 cases during 1 year).(ABSTRACT TRUNCATED AT 250 WORDS)

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Current consensus proposes a differentiated algorithm of initiation and intensification of antihyperglycaemic therapy in treatment patients withtype 2 diabetes mellitus. Patient-centered approach is considered a priority at any stage of diabetes care, as it ensures efficiency and safety of treatment.This document formulates guidelines for setting adequate therapeutic goals depending on vascular complications, age, life expectancy and riskof hypoglycemic events. Therapeutic options are stratified with regard to initial HbA1c level. This Algorithm considers all classes of antidiabetic medicationsregistered in Russian Federation, rational and irrational combinations of drugs as well as contraindications.

BackgroundThe effect of lixisenatide—a prandial once‐daily glucagon‐like peptide‐1 receptor agonist—on glycaemic control in patients with inadequately controlled type 2 diabetes mellitus (T2DM), stratified by baseline β‐cell function, was assessed.MethodsThe 24‐week GetGoal‐M, ‐P and ‐S trials evaluated the efficacy and safety of lixisenatide in combination with oral antidiabetic agents. This post hoc analysis used data from patients receiving lixisenatide in these trials, divided into matched cohorts by propensity scoring, and stratified according to baseline homeostasis model assessment of β‐cell function (HOMA‐β) index levels, high HOMA‐β: > median HOMA‐β (28.49%); low HOMA‐β: ≤ median.ResultsThe matched “low” and “high” HOMA‐β index cohorts (N = 546 patients) had comparable baseline parameters. Mean change from baseline in glycated haemoglobin (HbA1c) was −0.85% and −0.94% for low and high HOMA‐β cohorts, respectively (P = .2607). Reductions from baseline in fasting plasma glucose (FPG; −0.77 vs −1.04 mmol/L; P = .1496) and postprandial plasma glucose (PPG; −5.82 vs −5.61 mmol/L; P = .7511) were similar in the low versus high HOMA‐β index cohorts. Reduction in body weight was significantly greater in the low versus high HOMA‐β index cohort (–2.06 vs –1.13 kg, respectively; P = .0006).ConclusionsIn patients with T2DM, lixisenatide was associated with reduction in HbA1c and improvements in both FPG and PPG, regardless of β‐cell function, indicating that lixisenatide is effective in reducing hyperglycaemia, even in patients with more advanced stages of T2DM and poor residual β‐cell function.

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