Does addition of pramlintide to basal insulin improve glycemic control in type 2 diabetes mellitus?

This multicenter, longitudinal, descriptive, observational study of T2DM adults in Thailand aimed to assess real-world outcomes of basal insulin (BI) dose titration on glycemic control. Three-hundred and twenty-four patients were recruited and followed up over 24 weeks. Basal insulin titration was physician-driven in 58.2% of patients and patient-driven in the rest. During the 24-week study period, the total daily BI dose moved from 20.9 to 25.6 in the physician-driven group, while in the patient-driven group, it increased from 25.3 to 29.7. Thirty-five patients (11.2%) achieved their individualized HbA1c targets, with 18 patients (5.8%) achieving HbA1c ⩽ 7% without documented hypoglycemia. In summary, this study highlights that BI titration is suboptimal in the real world, and patients are unable to achieve their glycemic targets.

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Glycemic control and adherence to basal insulin therapy in Taiwanese patients with type 2 diabetes mellitus

Journal of Diabetes Investigation ◽

10.1111/jdi.12532 ◽

2016 ◽

Vol 7 (6) ◽

pp. 881-888 ◽

Cited By ~ 8

Author(s):

Ming‐Nan Chien ◽

Yen‐Ling Chen ◽

Yi‐Jen Hung ◽

Shu‐Yi Wang ◽

Wen‐Tsung Lu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Insulin Therapy ◽

Basal Insulin

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Does Initiation of Basal Insulin Analogs in Patients with Type 2 Diabetes Mellitus Confer Advantages over Neutral Protamine Hagedorn (NPH) for Severe Hypoglycemia and Glycemic Control?

Diabetes ◽

10.2337/db18-1311-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1311-P

Author(s):

KASIA J. LIPSKA ◽

MELISSA M. PARKER ◽

HOWARD H. MOFFET ◽

ELBERT HUANG ◽

ANDREW J. KARTER

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Basal Insulin ◽

Severe Hypoglycemia ◽

Insulin Analogs ◽

Neutral Protamine Hagedorn

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When basal insulin is not enough: successful strategies for insulin intensification in patients with type 2 diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm8824 ◽

2017 ◽

Vol 20 (5) ◽

pp. 363-373

Author(s):

Elena V. Buryukova ◽

Abdul Jabbar ◽

Svetlana V. Elizarova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Insulin Therapy ◽

Clinical Management ◽

Basal Insulin ◽

Insulin Intensification ◽

Advantages And Disadvantages

Maintaining glycemic control through intensive clinical management of patients with type 2 diabetes mellitus (T2DM) is well recognized to reduce the risk of diabetes-associated complications. Patients in Russia have high rates of microvascular and macrovascular complications as a result of undiagnosed, untreated, or inadequately treated diabetes, emphasizing the need for better clinical management. The introduction of basal insulin therapy is often necessary for patients with T2DM when oral antihyperglycemic drugs and lifestyle management strategies are no longer effective inmaintaining glycemic targets. However, after initiation of insulin, patients often remain on basal insulin for long periods despite suboptimal glycemic control, and intensification of insulin therapy is frequently necessary. Here, we report on several different insulin intensification strategies available to clinicians and their patients to improve glycemic control and the advantages and disadvantages of each approach. These strategies include the use of short- and long-acting insulins administered either as bolus doses or as premixed insulins. When selecting the most appropriate intensification strategy, clinicians should consider the lifestyle and treatment goals of their patients to help ensure treatment success.

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