2019
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Abstract: Aims To identify factors associated with achievement of glycated haemoglobin A1c (HbA1c) target at 24 weeks after commencing basal insulin therapy in individuals with type 2 diabetes mellitus (T2DM). Materials and methods Post‐hoc pooled analysis of 16 randomized, treat‐to‐target trials involving individuals with T2DM inadequately controlled with oral anti‐hyperglycaemic drugs (n = 3415) initiated on once‐daily insulin glargine 100 U/mL (Gla‐100). Clinica… Show more

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Cited by 12 publications
(17 citation statements)
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References 20 publications
(17 reference statements)
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“…These results of similar incidence but greater rates of hypoglycaemia might be interpreted as a signal of more aggressive BI titration by some individual patients with shorter diabetes duration versus physicians. It is worth noting that a shorter diabetes duration has been reported as an indicator of greater likelihood to achieve HbA 1c < 7.0% in a large global population [ 10 ]. The small increase in rates of hypoglycaemia observed only in the diabetes duration subgroup of patient-managed titration in the present post hoc analysis of ITAS in the context of similar incidence should be weighted versus the advantage for the patients who effectively reduce HbA 1c with self-management of BI.…”
Section: Discussionmentioning
confidence: 99%
“…Participant-level data were available from 16 RCTs of 24 weeks' duration conducted by Sanofi, the manufacturer of glargine 100 U/mL (Gla-100) (Lantus, Paris, France), between 2000 and 2015. 13,14 In nine trials baseline FCP was measured along with other biochemical markers including fasting plasma glucose (FPG) and HbA1c from the same blood samples. In three of these nine trials, FCP values of <0.25 nmol/L with positive antiglutamic acid decarboxylase (anti-GAD) levels met the exclusion criteria.…”
Section: Study and Participant Selectionmentioning
confidence: 99%
“…However, this alone may be insufficient for reaching glycemic goals in people with high initial HbA 1c levels. A pooled analysis of 16 RCTs indicated that 53.6% of people failing on OADs were unable to reach glycemic control (HbA 1c < 7%) when initiated with basal insulin, even in controlled trial settings [ 23 ]. An RWE study showed that, among individuals with an HbA 1c ≥ 9%, < 25% obtained HbA 1c < 7% within 12 months upon intensification with basal insulin or GLP-1 RA [ 5 ].…”
Section: Introductionmentioning
confidence: 99%
“…These algorithms uniformly adjust basal insulin based on fasting values obtained by self‐monitoring of blood glucose (SMBG) 4 . The strategy of bedtime dosing confers a comparatively low risk of hypoglycaemia 5 and is moderately effective at reducing HbA1c levels, with approximately half of participants in clinical studies achieving HbA1c levels of less than 7% or other individualized targets 6 . Unfortunately, basal insulin regimens that rely on infrequent SMBG testing and emphasize the control of fasting glucose and avoiding night‐time hypoglycaemia ignore the problems of daytime premeal and sustained postprandial hyperglycaemia, placing a ceiling effect on obtainable HbA1c reductions.…”
Section: Introductionmentioning
confidence: 99%
“…Unfortunately, basal insulin regimens that rely on infrequent SMBG testing and emphasize the control of fasting glucose and avoiding night‐time hypoglycaemia ignore the problems of daytime premeal and sustained postprandial hyperglycaemia, placing a ceiling effect on obtainable HbA1c reductions. Of greater concern, real‐world evidence shows that only ~30% of patients with T2D who use basal insulin maintain HbA1c levels of less than 7% 6–9 . There are many potential explanations for the discrepancy between evidence gained from clinical trials versus clinical practice.…”
Section: Introductionmentioning
confidence: 99%