| Strategies for insulin initiation: insights from the French LIGHT observational study. | |
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MedLine Citation:
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PMID: 22218757 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: The progressive nature of type 2 diabetes necessitates exogenous insulin use for most patients; basal insulin plus oral anti-diabetes drugs (OADs) is a well-validated way to facilitate insulin initiation. The primary aim of this study was to explore insulin initiation strategies and outcomes for patients using insulin detemir or glargine plus oral anti-diabetes drugs. METHODS: LIGHT was a 3-month, longitudinal observational study conducted across 761 French centres in insulin-naïve type 2 diabetes patients managed under routine clinical care conditions, in either primary or secondary care. Endpoints included changes in HbA(1c) , fasting plasma glucose (FPG), rate of hypoglycaemia, weight, and adverse events. RESULTS: Most physicians initiated a basal analogue to improve glycaemic control (97%), with many delaying beginning treatment for several months (9 ± 9.0 months for general practitioners, 10.2 ± 16.2 months for specialists). Most patients continued oral anti-diabetes drug therapy (95%) and lifestyle measures (92%), with 2-3 blood glucose readings per day and follow-up telephone calls for dose optimization. Mean change in HbA(1c) from baseline was - 1.3%, and - 3.1 mmol/L for fasting plasma glucose (both p < 0.0001). Hypoglycaemia increased from 1.4 to 5.6 events/patient/year (p < 0.0001), and weight decreased on average by 0.5 kg with detemir, with no change in glargine. Most patients (93%) reported being satisfied or very satisfied with their insulin. CONCLUSIONS: Insulin initiation with detemir or glargine can be successfully managed in both primary and secondary care; the benefits of basal analogues (once-daily dosing, low rates of hypoglycaemia compared with neutral protamine Hagedorn) may have contributed to patient acceptance of the regimen. Copyright © 2012 John Wiley & Sons, Ltd. |
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Authors:
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Bruno Vergès; Jean Marcel Brun; Camille Tawil; Bertrand Alexandre; Véronique Kerlan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes/metabolism research and reviews Volume: 28 ISSN: 1520-7560 ISO Abbreviation: Diabetes Metab. Res. Rev. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-01-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883450 Medline TA: Diabetes Metab Res Rev Country: England |
Other Details:
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Languages: eng Pagination: 97-105 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 John Wiley & Sons, Ltd. |
Affiliation:
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Dijon Université Hôpital, Dijon, France. bruno.verges@chu-dijon.fr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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