Switching from premixed insulin to basal-bolus insulin glargine plus rapid-acting insulin: The atlantic study
(2013) Acta Clinica Belgica (Multilingual Edition) — Vol. 68, n° 1, p. 28-33 (2013)
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- Abstract
- Data on switching from premixed insulin to a basal.bolus regimen in routine clinical practice are sparse. The aim was to evaluate the efficacy and safety of switching from twice-daily premixed insulin to basal glargine plus rapid-acting insulin in a greal-worldh clinical practice setting in Belgium and The Netherlands. Methods: This prospective, 6-month, noninterventional, observational study was conducted in 37 centres in Belgium and 19 centres in The Netherlands. Adults (≥ 18 years of age) with type 2 diabetes were eligible if they were not taking oral antihyperglycaemic drugs or only taking metformin. The primary objective was the proportion of patients attaining glycated haemoglobin (HbA1c) < 7% at months 3 and 6. Secondary objectives included changes in HbA<inf>1c</inf>, weight, body mass index (BMI), insulin doses, hypoglycaemic events, and treatment satisfaction. Results: There were 214 patients from Belgium and The Netherlands enrolled. Mean age was 64.6 years, weight was 89.5 kg, BMI was 31.4 kg/m<sup>2</sup>, and duration of diabetes was 12.1 years. At month 6, the percentage of patients with HbA<inf>1c</inf> < 7% increased from 3.3% to 24.9% (p < 0.001). Mean HbA<inf>1c</inf> at baseline was 8.9%; mean change from baseline was -1.5% (p < 0.001). Glargine and prandial insulin doses increased (p < 0.001, each), while body weight and BMI were unchanged. Hypoglycaemic events did not increase. Overall treatment satisfaction improved significantly (p < 0.001). Conclusions: In a Belgian and Dutch clinical practice setting, patients with type 2 diabetes that is poorly controlled on premixed insulin experienced significant improvements in glycaemic control, without a concomitant increase in hypoglycaemic events or weight, when switched from premixed insulin to basal-bolus glargine plus rapid-acting insulin. As a result, treatment satisfaction significantly improved.
Citations
Mathieu, C., Storms, F., Tits, J., Veneman, T. F., & Colin, I. M. (2013). Switching from premixed insulin to basal-bolus insulin glargine plus rapid-acting insulin: The atlantic study. Acta Clinica Belgica (Multilingual Edition), 68(1), 28-33. https://doi.org/10.2143/ACB.68.1.2062716 (Original work published 2013)