TY - JOUR
T1 - Evaluation of insulin regimens as an effective option for glycemic control in patients with type 2 diabetes
T2 - A propensity score-matched cohort study across Japan (JDDM31)
AU - Japan Diabetes Clinical Data Management Study Group
AU - Kanatsuka, Azuma
AU - Sato, Yasunori
AU - Kawai, Koichi
AU - Hirao, Koichi
AU - Kobayashi, Masashi
AU - Kashiwagi, Atsunori
AU - Abe, Nobuyuki
AU - Arai, Keiko
AU - Fujiya, Hiroshi
AU - Fukumoto, Yoshihide
AU - Dake, Fumihiko
AU - Iizumi, Tomohiro
AU - Ito, Masaaki
AU - Iwasaki, Koichi
AU - Kanamori, Akira
AU - Kato, Sumio
AU - Kato, Masakazu
AU - Kawara, Akira
AU - Kimura, Kenichi
AU - Chikamori, Kazumasa
AU - Iemitsu, Kotaro
AU - Kou, Shigetake
AU - Kudo, Mikihiko
AU - Kurihara, Yoshio
AU - Lee, Gendai
AU - Tsuruoka, Akira
AU - Manda, Naoki
AU - Matoba, Kiyokazu
AU - Hayashi, Hiroshi
AU - Minami, Masae
AU - Kuribayashi, Nobuichi
AU - Miyazawa, Kazuhiro
AU - Chiba, Yasuko
AU - Osonoi, Takeshi
AU - Nakamura, Shin
AU - Sasaki, Hideo
AU - Komori, Katsutoshi
AU - Oishi, Mariko
AU - Okada, Akira
AU - Okuguchi, Fuminobu
AU - Yanagisawa, Morifumi
AU - Sugimoto, Hidekatsu
AU - Sugiyama, Hiromichi
AU - Takai, Masahiko
AU - Takaki, Masato
AU - Takamura, Hiroshi
AU - Takeda, Hiroshi
AU - Tanaka, Kokichi
AU - Miwa, Takashi
AU - Tomonaga, Osamu
N1 - Publisher Copyright:
© 2014 The Authors.
PY - 2014
Y1 - 2014
N2 - Aims/Introduction: We evaluated the long-term efficacy of insulin regimens in patients with type 2 diabetes mellitus and poor glycemic control despite oral antidiabetic drugs (OAD). Materials and Methods: We carried out a propensity score-matched cohort study using the CoDiC® database of the Japan Diabetes Data Management Study Group across 54 institutions in Japan from 2005 to 2010. A total of 10,854 patients on OAD in 2005 were studied, and 1,253 patients (11.5%) were treated with insulin until 2010. The changes in insulin regimens and glycated hemoglobin (HbA1c) levels were analyzed over this study period. Results: Propensity score matching showed no differences in the baseline patient characteristics. A total of 96 patients transferred to insulin, and HbA1c gradually and significantly decreased in the patients on a twice-daily premixed preparation of rapid-acting human-insulin analogs (twice-daily MIX) and basal-bolus therapy with rapid-acting human-insulin analogs (RA) plus long-acting insulin analog (LA; P < 0.001). A total of 418 patients had insulin added to OAD treatment, and HbA1c decreased in the patients with a twice-daily MIX (P < 0.001), but HbA1c did not differ from the baseline values in the patients on basal LA (P = 0.497). The mean decline in HbA1c at the end of the study was therefore larger in the patients receiving twice-daily MIX than in the patients receiving basal LA (P < 0.05). Conclusion: The present study could suggest the potential loss of opportunity for many patients treated using basal LA to have received alternative insulin regimens and to achieve better glycemic control.
AB - Aims/Introduction: We evaluated the long-term efficacy of insulin regimens in patients with type 2 diabetes mellitus and poor glycemic control despite oral antidiabetic drugs (OAD). Materials and Methods: We carried out a propensity score-matched cohort study using the CoDiC® database of the Japan Diabetes Data Management Study Group across 54 institutions in Japan from 2005 to 2010. A total of 10,854 patients on OAD in 2005 were studied, and 1,253 patients (11.5%) were treated with insulin until 2010. The changes in insulin regimens and glycated hemoglobin (HbA1c) levels were analyzed over this study period. Results: Propensity score matching showed no differences in the baseline patient characteristics. A total of 96 patients transferred to insulin, and HbA1c gradually and significantly decreased in the patients on a twice-daily premixed preparation of rapid-acting human-insulin analogs (twice-daily MIX) and basal-bolus therapy with rapid-acting human-insulin analogs (RA) plus long-acting insulin analog (LA; P < 0.001). A total of 418 patients had insulin added to OAD treatment, and HbA1c decreased in the patients with a twice-daily MIX (P < 0.001), but HbA1c did not differ from the baseline values in the patients on basal LA (P = 0.497). The mean decline in HbA1c at the end of the study was therefore larger in the patients receiving twice-daily MIX than in the patients receiving basal LA (P < 0.05). Conclusion: The present study could suggest the potential loss of opportunity for many patients treated using basal LA to have received alternative insulin regimens and to achieve better glycemic control.
KW - Insulin regimens
KW - Propensity score-matched analysis
KW - Type 2 diabetes mellitus
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U2 - 10.1111/jdi.12194
DO - 10.1111/jdi.12194
M3 - Article
AN - SCOPUS:84908566861
VL - 5
SP - 539
EP - 547
JO - Journal of Diabetes Investigation
JF - Journal of Diabetes Investigation
SN - 2040-1116
IS - 5
ER -