Predictors for achieving target glycemic control in Japanese patients with type 2 diabetes after initiation of basal supported oral therapy using insulin glargine: sub-analysis of the ALOHA2 study, drug use surveillance in Japan.

Abstract

We aimed to identify diabetes-related factors associated with achieving HbA1c <7.0% after the initiation of basal supported oral therapy (BOT) in insulin-naïve type 2 diabetes patients with an HbA1c value of ≥6.5% during the previous 4weeks, using data from Add-on Lantus® to Oral Hypoglycemic Agents 2 (ALOHA2) study, a 24-week observational study on Japanese type 2 diabetes patients. Patients were categorized into two groups: HbA1c <7.0% at the final evaluation point (at 24weeks or the last visit) as HbA1c-target-achieved; HbA1c ≥7.0% as target-not-achieved. Associations between baseline factors and HbA1c <7.0% achievement were explored using logistic regression. Of the 1520 patients in the study, 400 patients (26.3%) achieved HbA1c <7.0%. Patients with diabetes duration of <1year and between ≥1 and <2years [odds ratio (OR): 5.27, 95% confidence interval (CI): 1.13-24.51; OR: 3.77, 95% CI 1.19-11.93, respectively], those on one pre-study orally administered antidiabetic agent (OAD) (OR: 2.42, 95% CI 1.12-5.22), and those with absence of diabetic neuropathy (OR: 2.54, 95% CI 1.12-5.76) were more likely to achieve HbA1c <7.0% than those with duration of ≤15years, ≥4 pre-study OADs, and neuropathy, respectively. Achievement of HbA1c <7.0% among patients increased by approximately 20% for each 1% decrease in HbA1c level at baseline. Shorter diabetes duration, pre-study regimen of one OAD, absence of neuropathy, and lower HbA1c level at baseline were associated with achievement of HbA1c <7.0%, suggesting that earlier initiation of BOT leads to good HbA1c control in insulin-naïve Japanese type 2 diabetes patients, consistent with our early ALOHA study.