Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1399
10
1
gregorian
2021
1
1
35
1
online
1
fulltext
en
The Impact of Adding Prandial Insulin to a Basal Based Regimen with Insulin Glargine in Type 2 Diabetic Patients
Endocrinology
Endocrinology
Original Research
Original Research
<strong>Background: </strong>Type 2 diabetes (T2D) is a progressive disease that should be managed with insulin in case of oral glucose lowering drugs (OGLDs) failure. If basal insulin is not sufficient, rapid acting insulin will be added before the largest meal. We assessed the impact of adding one prandial insulin to a basal based regimen and insulin glargine in patients with type 2 diabetes to measure the percentage of subjects achieving the HbA1c target by the end of 24 weeks of treatment in routine clinical practice.<br>
<strong>Methods:</strong> This study was a 24-week observational study of patients with T2D not adequately controlled with OGLDs and basal insulin, for whom the physician had decided to initiate prandial insulin. The study endpoint was assessed at visit 1 (baseline), visit 2 at week 12 (±1 week) and visit 3 at week 24 (±1 week). The percentage of patients who achieved HbA1c targets was assessed at week 24. Statistical analyses were performed using IBM SPSS for Windows v 19 (IBM, Armonk, New York, USA). Logistic regression analysis was used to detect predicting factors of achieving the HbA1c target by week 24. P<0.05 was considered as significant level.<br>
<strong>Results:</strong> Four hundred and eighteen patients with a mean±SD age of 56.24±9.85 years and a mean±SD duration of diabetes of 12.50±7.16 years were included. The median total daily dose of basal insulin was 24 units, while prandial insulin was started with 6 (4, 10) U/day, titrating up to 10 (8, 18) U/day at week 24. The daily dose of prandial insulin was the only factor that could significantly predict achieving targeted HbA1c by week 24 [OR: 1.04; 95% CI: 1.007,1.079; p-value: 0.019]. At week 24, 96 (22.9%) subjects achieved the HbA1c target with one prandial insulin.<br>
<strong>Conclusion:</strong> The results of our study suggest that “basal plus therapy” can lead to good glycemic control with a low risk of hypoglycemia and weight gain in patients with type 2 diabetes.
Safety, Treatment Outcome, Diabetes Mellitus type 2, Insulin, Short-Acting, Glycated Hemoglobin A
1207
1213
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-4883-1&slc_lang=en&sid=1
Mohammad Ebrahim
Khamseh
khamseh.m@iums.ac.ir
200319475328460066852
200319475328460066852
No
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
Zahra
Abbasi Ranjbar
Drabbasi.ranjbar@gmail.com
200319475328460066853
200319475328460066853
No
Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Zahra
Banazadeh
zbanazadeh01@gmail.com
200319475328460066854
200319475328460066854
No
Lolagar Hospital, Iran University of Medical Sciences, Tehran, Iran
Mani
Mirfeizi
mani@kiau.ac.ir
200319475328460066855
200319475328460066855
No
Department of Midwifery, College of Nursing & Midwifery, Karaj Branch, Islamic Azad University, Karaj, Iran
Manouchehr
Mohammadbeiki
mohammadbeigimanouchehr@gmail.com
200319475328460066856
200319475328460066856
No
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Zohreh
Mozafari
Zohreh.mozafari@sanofi.com
200319475328460066857
200319475328460066857
No
Sanofi Iran, Tehran, Iran
Kamnoosh
Razazian
Kamnoosh1342@gmail.com
200319475328460066858
200319475328460066858
No
Sohrabi Clinic, Tehran, Iran
Mojtaba
Malek
malek.m@iums.ac.ir
200319475328460066859
200319475328460066859
Yes
Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran