Patient characteristics and 6‐month dose of basal insulin associated with <scp>HbA1c</scp> achievement &lt;7.0% in Chinese people with type 2 diabetes: results from the Observational Registry of Basal Insulin Treatment (<scp>ORBIT</scp>)

Gao, Leili; Zhang, Puhong; Weng, Jianping; Lu, Juming; X, Guo; Jia, Weiping; Yang, Wenying; Zou, Da-jin; Zhang, Zhou; Pan, Changyu; Gao, Yan; Li, Xian; Zhu, Dongshan; Wu, Yangfeng; Garg, Satish K.; Ji, Linong

doi:10.1111/1753-0407.13046

Cited by 7 publications

(13 citation statements)

References 24 publications

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“…Moreover, we investigated the factors that might influence the choice of insulin regimens of the doctors, and we found that the doctors preferred to prescribe twice‐daily premixed insulin (31.98 [11.04] IU/d at initiation) rather than once‐daily basal insulin (12.51 [5.38] IU/d at initiation) to those who had higher BMI and HbA1c levels at initiation. The daily insulin dosages used in the present study in each group were similar to those found in other studies 15,23 . These findings suggested that doctors preferred the twice‐daily administration of insulin to those with higher insulin dosages used (given on the basis of patient body weight) or with poorer glycemic control at initiation.…”

Section: Discussionsupporting

confidence: 85%

“…The daily insulin dosages used in the present study in each group were similar to those found in other studies. 15 , 23 These findings suggested that doctors preferred the twice‐daily administration of insulin to those with higher insulin dosages used (given on the basis of patient body weight) or with poorer glycemic control at initiation. However, when we further stratified patients into different HbA1c and BMI subgroups, the results showed no difference in the efficacies of glycemic control between the two insulin treatment groups in either the HbA1c < 9% or ≥ 9% subgroups ( p = 0.64 and 0.21, respectively) or the BMI < 25 or ≥ 25 kg/m 2 subgroups ( p = 0.95, and 0.23, respectively).…”

Section: Discussionmentioning

confidence: 99%

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Effects of basal and premixed insulin on glycemic control in type 2 diabetes patients based on multicenter prospective real‐world data

Peng

Shi

et al. 2022

Journal of Diabetes

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Background To investigate the different efficacies of glycemic control between basal and premixed insulin in participants with type 2 diabetes (T2DM) when non‐insulin medications fail to reach treatment targets. Methods This was a prospective, large‐scale, real‐world study at 10 diabetes centers in China. Between June 2017 and June 2021, we enrolled 1104 T2DM participants initiated with either once‐daily basal insulin or twice‐daily premixed insulin when the glycosylated hemoglobin (HbA1c) control target was not met after at least two non‐insulin agents were administered. A Cox proportional hazards regression model adjusting for multiple influencing factors was performed to compare the different effects of basal and premixed insulin on reaching the HbA1c control target. Results At baseline, basal insulin (57.3%) was prescribed more frequently than premixed insulin (42.7%). Patients with a higher body mass index (BMI) or higher HbA1c levels were more likely to receive premixed insulin than basal insulin (both p < 0.001). After a median follow‐up of 12.0 months, compared to those with premixed insulin, the hazard ratio for reaching the HbA1c target to those with basal insulin was 1.10 (95% CI, 0.92‐1.31; p = 0.29) after adjustment, and less weight gain was observed in those with basal insulin than with premixed insulin (percentage change of BMI from baseline −0.37[5.50]% vs 3.40[6.73]%, p < 0.0001). Conclusions In this real‐world study, once‐daily basal insulin was more frequently prescribed and had similar glycemic control effects but less weight gain compared with twice‐daily premixed insulin when used as initiation therapy for those in whom glycemic control with non‐insulin medications failed.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Effects of basal and premixed insulin on glycemic control in type 2 diabetes patients based on multicenter prospective real‐world data

Peng

Shi

et al. 2022

Journal of Diabetes

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“…At the end of the study, the mean (±SD) dose of glargine was 0.22 ± 0.08 and 0.15 ± 0.06 units/kg/day for NPH. 16…”

Section: Glargine Versus Nphmentioning

confidence: 99%

The Comparative Dosing and Glycemic Control of Intermediate and Long-Acting Insulins in Adult Patients With Type 1 and 2 Diabetes Mellitus

Kabakov

Merker

2021

Journal of Pharmacy Technology

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Objective: The various basal insulin products possess differences in pharmacokinetics that can significantly impact glycemic control and total daily basal insulin dosing. In addition, there will be instances where transitions between the different long-acting insulins will need to be made. Because every basal insulin product is not interchangeable on a 1:1 unit-to-unit basis, it is important for health care providers to understand the expected dose adjustments necessary to maintain a similar level of glycemic control. Data Sources: A Medline and Web of Science search was conducted in September 2021 using the following keywords and medical subjecting headings: NPH, glargine, detemir, type 1 diabetes mellitus, and type 2 diabetes mellitus. Study Selection and Data Extraction: Included articles were those that followed adult patients with type 1 diabetes mellitus and/or type 2 diabetes mellitus and compared the following types of insulin: “NPH and glargine,” “NPH and detemir,” and “glargine and detemir” for at least 4 weeks, had documented basal insulin (BI) doses, and excluded pregnant patients. Data synthesis: Twenty-five articles were found that include adult type 1 and/or type 2 diabetes mellitus patients. Once daily NPH can be converted unit-to-unit to glargine or detemir. Twice daily NPH converted to glargine or detemir requires an initial 20% reduction in BI dose. An increase in dose of BI is recommended when transitioning from glargine to detemir. Glargine and detemir consistently resulted in improved glycemic control with lower incidence of hypoglycemic events compared with NPH. Conclusions: When transitioning between long-acting insulins, the doses are not always interchangeable on a 1:1 basis. Unit dose adjustments are likely if transitioning between BIs and can influence short-term parameters in the acute care setting and long-term parameters in the outpatient setting.

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“…Diabetes and related comorbidities were the leading cause of death in China in 2019 [ 2 ]. Chinese T2DM patients are characterized by a relatively young age, a low BMI, and significant IR [ 3 , 4 ]. It is well documented that the two major pathological features of T2DM are IR and β-cell dysfunction [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

TyG Index Performs Better Than HOMA-IR in Chinese Type 2 Diabetes Mellitus with a BMI < 35 kg/m2: A Hyperglycemic Clamp Validated Study

Luo

Cao

et al. 2022

Medicina

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Background and objectives: Chinese type 2 diabetes mellitus (T2DM) patients are characterized by a low body mass index (BMI), and significant insulin resistance (IR). The triglyceride glucose (TyG) index has not been studied as a means of assessing IR in Chinese T2DM patients with a BMI < 35 kg/m2. Materials and Methods: An open-label cross-sectional study recruited 102 Chinese T2DM patients with a BMI < 35 kg/m2. The hyper-insulinemic euglycemic clamp, homeostatic model assessment of IR (HOMA-IR), and TyG index were used to determine the level of IR. Based on Pearson’s correlations, glucose disposal rate (GDR), TyG index, and HOMA-IR were analyzed. HOMA-IR and TyG index for IR were evaluated using multiple linear regression and multivariate logistic regression analyses. On the basis of the receiver operating characteristic (ROC) curve, the sensitivity, specificity, and optimal cut-off value of HOMA-IR and the TyG index were determined. Results: The mean values of GDR, HOMA-IR, and TyG index were 4.25 ± 1.81, 8.05 ± 7.98, and 8.12 ± 0.86 mg/kg/min, respectively. Pearson’s correlation coefficient was −0.418 between GDR and TyG index and −0.324 between GDR and HOMA-IR. ROC curve analysis showed that, among both sexes, the TyG index was a better discriminator of IR than HOMA-IR. The area under the ROC curve (AUC) of the TyG index (0.785, 0.691–0.879) was higher than that of HOMA-IR (0.73, 0.588–0.873) in all genders. The optimal cut-off values of the TyG index and HOMA-IR were 7.99 and 3.39, respectively. Conclusions: The TyG index showed more effectiveness in identifying IR in Chinese T2DM patients with a BMI < 35 kg/m2 compared to HOMA-IR.

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Patient characteristics and 6‐month dose of basal insulin associated with HbA1c achievement <7.0% in Chinese people with type 2 diabetes: results from the Observational Registry of Basal Insulin Treatment (ORBIT)

Cited by 7 publications

References 24 publications

Effects of basal and premixed insulin on glycemic control in type 2 diabetes patients based on multicenter prospective real‐world data

Effects of basal and premixed insulin on glycemic control in type 2 diabetes patients based on multicenter prospective real‐world data

The Comparative Dosing and Glycemic Control of Intermediate and Long-Acting Insulins in Adult Patients With Type 1 and 2 Diabetes Mellitus

TyG Index Performs Better Than HOMA-IR in Chinese Type 2 Diabetes Mellitus with a BMI < 35 kg/m2: A Hyperglycemic Clamp Validated Study

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