Abstract
We aimed to evaluate the efficacy of, and treatment satisfaction with, insulin glargine administered with SoloSTAR® or ClikSTAR® pens in patients with type 2 diabetes mellitus managed by primary care physicians in Switzerland. A total of 327 patients with inadequately controlled type 2 diabetes were enrolled by 72 physicians in this prospective observational study, which aimed to evaluate the efficacy of a 6-month course of insulin glargine therapy measured as development of glycaemic control (glycosylated haemoglobin [HbA1c] and fasting plasma glucose [FPG]) and weight change. We also assessed preference for reusable or disposable pens, and treatment satisfaction. After 6 months, the mean daily dose of insulin glargine was 27.7±14.3 U, and dose titration was completed in 228 (72.4%) patients. Mean HbA1c decreased from 8.9%±1.6% (n=327) to 7.3%±1.0% (n=315) (p<0.0001), and 138 (43.8%) patients achieved an HbA1c≤7.0%. Mean FPG decreased from 10.9±4.5 to 7.3±1.8 mmol/l (p<0.0001). Mean body weight did not change (85.4±17.2 kg vs 85.0±16.5 kg; p=0.11). Patients' preference was in favour of the disposable SoloStar® pen (80%), as compared with the reusable ClickStar® pen (20%). Overall, 92.6% of physicians and 96.3% of patients were satisfied or very satisfied with the insulin glargine therapy. In patients with type 2 diabetes insulin glargine administered by SoloSTAR® or ClikSTAR® pens, education on insulin injection and on self-management of diabetes was associated with clinically meaningful improvements in HbA1c and FPG without a mean collective weight gain. The vast majority of both patients and primary care physicians were satisfied with the treatment intensification.
Highlights
Diabetes mellitus represents a fast growing worldwide epidemic: In 2010, an estimated 285 million people were affected by type 2 diabetes
PRINCIPLES: We aimed to evaluate the efficacy of, and treatment satisfaction with, insulin glargine administered with SoloSTAR® or ClikSTAR® pens in patients with type 2 diabetes mellitus managed by primary care physicians in Switzerland
A total of 327 patients with inadequately controlled type 2 diabetes were enrolled by 72 physicians in this prospective observational study, which aimed to evaluate the efficacy of a 6-month course of insulin glargine therapy measured as development of glycaemic control and weight change
Summary
Diabetes mellitus represents a fast growing worldwide epidemic: In 2010, an estimated 285 million people were affected by type 2 diabetes. In patients with type 2 diabetes, hyperglycaemia enhances the risk of vascular disease, acute myocardial infarction, stroke, lower limb amputation and microvascular complications [2,3,4,5,6]. Once life-style intervention and one or more oral antidiabetic drugs (OADs) become ineffective to lower HbA1c to target levels, the addition of basal insulin, in patients with high fasting blood glucose (FBG) levels, is highly recommended [8]. Type 2 diabetes guidelines and algorithms that highlight the importance of basal insulin for the management of the disease have been published in recent years jointly by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Whereas the addition of basal insulin to existing OAD treatment was
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