scholarly journals Results of the observational program on the use of insulin glargine (Lantus) in combination with oral hypoglycemic agents or prandial insulins for the treatment of type 2 diabetes mellitus in routine clinical practice

2010 ◽  
Vol 56 (5) ◽  
pp. 61-66
Author(s):  
I V Glinkina

The objective of this observational program was to evaluate the efficiency and safety of insulin glargine used to treat patients with type 2 diabetes mellitus (DM2) who failed to achieve adequate compensation of carbohydrate metabolism during therapy with NPC insulin in combination with oral hypoglycemic agents or prandial insulins. The secondary objective was to estimate satisfaction of physicians with the results of insulin glargine therapy. The open, prospective non-randomized multicentre observational study included 7.334 patients of the mean age 58.3±9.0 years presenting with type 2 diabetes mellitus and treated using a combination of NPC insulin and oral hypoglycemic agents or prandial insulins. The mean duration of the disease was 10.5±4.7 years, HbA<inf>1c</inf> level 9.6±1.7%, fasting blood glucose level 10.3±2.5 mmol/l. The total duration of the study was 6 months. After inclusion in the program, the patients were transferred from NPC insulin to insulin glargine with subsequent titration of the dose. The HbA<inf>1c</inf> level decreased from 9.6±1.7% to 8.0±1.2% and 7.2±1.0% within 3 and 6 months after the inclusion into the study respectively (p<0.001 for both values). The fasting blood glucose levels exhibited a similar trend. The target HbA<inf>1c</inf> level of ≤ 7% was achieved within 3 months in 29.2% of the patients and within 6 months in 53.8%. Simultaneously a reduction in the incidence of mild and severe hypoglycemic symptoms was documented both during the daytime and at night. The physicians described the results of the treatment as "good" and "very good" in 80.7% and 93.2% of the patients 3 and 6 months respectively after transfer from NPC insulin to insulin glargine in combination with oral hypoglycemic agents. It is concluded that substitution of NPC insulin by insulin glargine for the treatment of patients presenting with type 2 diabetes mellitus not only improves the quality of glycemic control but also significantly reduces the frequency of mild and severe hypoglycemic symptoms.

2013 ◽  
Vol 59 (4) ◽  
pp. 65-68
Author(s):  
M G Pavlova ◽  
I V Glinkina

The results of numerous clinical investigations carried out during the last years provide convincing evidence of the high effectiveness and safety of early initiation of insulin therapy. Of special interest are the studies conducted under conditions of real clinical practice. One of them is the Russian SOLOS observational program designed to evaluate the influence of intensification of the treatment of type 2 diabetes mellitus with oral hypoglycemic agents (OHA) supplemented by using insulin glargine in the patients who failed to be adequately compensated by OHA therapy alone. Another objective of this program was to find out the opinion of the patients and physicians about the SoloStar pen employed for injecting insulin glargine. The data concerning 1309 patients at the mean age of 59.5±8.8 years with type 2 diabetes mellitus and the mean duration of the disease 6.9±5.0 years were available for the analysis. The overwhelming majority of the patients presented with severe decompensation of carbohydrate metabolism, the mean fasting blood glucose level being 10.7±2.4 mmol/l and the HbA1c level varying from 7.2 to 18.2% (mean 9.6±1.5%). Supplementation of OHA therapy with insulin glargine caused the significant reduction of the HbA1c level to 8.1±1.0% (p<0.001) within 3 months after the onset of the combined treatment. The HbA1c level fell down to 7.2±0.9% (p<0.001) after 6 months 40.6% of the patients had HbA1c at the level below 7%. Fasting blood glucose levels decreased to 7.4±1.4 mmol/l and 6.3±1.0 mmol/l (p<0.001) at 3 and 6 months after the onset of insulin administration respectively. The number of daytime and nocturnal hypoglycemic episodes under effect of insulin glargine injections significantly decreased by the end of the study. Severe hypoglycemic episodes suffered initially by 8 (0.5%) patients totally disappeared 6 months after the initiation of the combined therapy. Most patients did not need hospitalization after supplementation of OHA treatment with insulin. The results of combined therapy with the use of disposable SoloStar pens were positively assessed by the overwhelming majority of both the patients and the physicians involved in the study.


2021 ◽  
Vol 6 (1) ◽  
pp. 79-86
Author(s):  
Fef Rukminingsih ◽  

Diabetes mellitus (DM) type 2 is a chronic and progressive clinical syndrome, characterized by polyuria, polydipsi and polyphagy accompanied by increased blood glucose or hyperglycemia. Management of type 2 diabetes mellitus in patients with HbA1C values > 9% is by administering insulin or a combination of insulin with oral hypoglycemic agents. This study aims to determine the suitability of the type and dose of insulin in type 2 DM patients in the Outpatient Pharmacy Installation of St. Elisabeth Hospital Semarang. This research is a descriptive observational study using retrospective data. The data were obtained from the medical records of Universal Health Coverage participant patients with type 2 diabetes mellitus in the Outpatient Pharmacy Installation of St. Elisabeth Hospital Semarang, who only received insulin therapy in January 2020, is 26-65 years old, and has examination results for fasting blood glucose, post prandial blood glucose and HbA1C (examination results for the last 6 months). The results showed that 57 patients consisted of 29 (50.88%) male patients and 28 (49.12%) female patients. A total of 47 (82.46%) patients were more than 45 years old. A total of 38 patients (66.67%) received combination insulin and all patients had HbA1C values> 9%. The suitability of using insulin based on the type of insulin was 68.42% and most of the patients (80.70%) received inappropriate insulin doses.


2012 ◽  
Vol 58 (3) ◽  
pp. 56-60
Author(s):  
I R Iarek-Martynova

The onset of insulin therapy is an important stage in the treatment of type 2 diabetes mellitus. Its timely beginning ensures better control of glycemia and reduces the negative consequences of chronic glucose cytotoxicity and lipotoxicity. The achievement and maintenance of the stable compensation of the disease are the indispensable conditions for successful prophylaxis and adequate treatment of chronic complications of diabetes mellitus. The ADA guidelines recommend to initiate insulin therapy at the early stages of the disease provided it is dictated by the clinical situation or combine it with the use of oral hypoglycemic agents if the targeted HbA1c levels fail to be reached despite the intake of one or more tableted preparations.


2017 ◽  
Vol 41 (5) ◽  
pp. 357 ◽  
Author(s):  
Min Kyong Moon ◽  
Kyu-Yeon Hur ◽  
Seung-Hyun Ko ◽  
Seok-O Park ◽  
Byung-Wan Lee ◽  
...  

2016 ◽  
Vol 63 (10) ◽  
pp. 519-526
Author(s):  
Irene Romera ◽  
Francisco Javier Ampudia-Blasco ◽  
Antonio Pérez ◽  
Bernat Ariño ◽  
Egon Pfarr ◽  
...  

2013 ◽  
Vol 59 (5) ◽  
pp. 72-80
Author(s):  
Iu Sh Khalimov

The incidence of hypoglycemia remains rather high among the population of patients with type 2 diabetes mellitus (DM2) especially in those treated with the traditional oral hypoglycemic agents. Hypoglycemia is one of the most frequent adverse events encountered by a physician dealing with diabetic (DM2) patients. At the same time, the novel approaches are currently available that allow this clinical condition to be avoided.


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