Comparative effectiveness and safety of different basal insulins in a real‐world setting

Abstract

In a real-world clinical setting in China, treatment with long-acting insulin analogues was associated with better glycaemic control, as well as less hypoglycaemia and weight gain than treatment with NPH insulin in type 2 diabetes patients. However, the clinical relevance of these observations must be interpreted with caution.

<p>Achieving Effective and Efficient Basal Insulin Optimal Management by Using Mobile Health Application (APP) for Type 2 Diabetes Patients in China</p>

“…Previous ORBIT study has shown that the average HbA1c level of onset insulin therapy in T2D in China was 9.6%. [11][12][13] However, this does not meet the recommendation of the Chinese guidelines for the prevention and treatment of T2D that patients with HBA1c levels above 7% of the oral medicines that do not meet the standard should start insulin therapy, 14 which suggested that the current situation of using basic insulin in clinic is late and clinical inertia exists. Therefore, the timing of initial treatment of basic insulin is particularly important.…”

“…Moreover, in more than 40% of these patients, the insulin dosage did not change during the first 3 months of basal insulin treatment. [11][12][13] Therefore, we carried out this program, by using the mobile health application (APP) in basal insulin optimal management program for insulin-naive T2D patients in China, the effectiveness of this kind of education in telemedicine was to be evaluated.…”

Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review

“…The ORBIT prospective study, conducted in China between 2011 and 2013, provided insight into results of basal insulin treatment in a large cohort (16,341 patients completed 6 months follow-up) of Chinese patients with T2DM inadequately treated with OAMs [ 30 , 39 ]. Baseline HbA1c levels were high [mean HbA1c among patients starting basal insulin therapy was 9.6% (81 mmol/mol)] [ 30 ]. Among patients with available data after 3 and 6 months of therapy, glycemic control improved significantly at 6 months with an overall reduction in HbA1c of 2.1% (23 mmol/mol) [2.2% (24 mmol/mol) in the IGlar cohort].…”

“…Among uncontrolled patients, more than 30% did not report dose titration between consecutive visits [ 39 ]. The study results indicate that initiation of basal insulins in a real-world setting was associated with minor weight gain (0.10 kg over 6 months in the entire study cohort, 0.09 kg in an IGlar cohort [ 30 ]) and no significant increase in hypoglycemia risk from before basal insulin initiation to 6 months after initiation [ 39 ]. The rate of general hypoglycemia was significantly lower in patients treated with IGlar vs insulin detemir or NPH insulin [ 30 ].…”

“…The study results indicate that initiation of basal insulins in a real-world setting was associated with minor weight gain (0.10 kg over 6 months in the entire study cohort, 0.09 kg in an IGlar cohort [ 30 ]) and no significant increase in hypoglycemia risk from before basal insulin initiation to 6 months after initiation [ 39 ]. The rate of general hypoglycemia was significantly lower in patients treated with IGlar vs insulin detemir or NPH insulin [ 30 ]. Similar to the Japanese ALOHA findings, low risk of hypoglycemia and low weight gain do not explain the lack of effective insulin titration in Chinese participants of this study.…”