Achievement of Target A1C <7.0% (<53 mmol/mol) by U.S. Type 2 Diabetes Patients Treated With Basal Insulin in Both Randomized Controlled Trials and Clinical Practice
| Autor: | Rong Zhou, Andres DiGenio, Mehul Dalal, Keith L. Davis, Juliana Meyers, Stephen A. Brunton, Pavan Chava, Lawrence Blonde |
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| Rok vydání: | 2019 |
| Předmět: |
Diabetes duration
medicine.medical_specialty endocrine system diseases business.industry Endocrinology Diabetes and Metabolism Basal insulin nutritional and metabolic diseases 030209 endocrinology & metabolism Type 2 diabetes medicine.disease Feature Articles law.invention Clinical Practice 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Diabetes mellitus Internal Medicine medicine Insulin titration 030212 general & internal medicine business Glycemic |
| Zdroj: | Diabetes Spectrum : A Publication of the American Diabetes Association |
| ISSN: | 1944-7353 1040-9165 |
| DOI: | 10.2337/ds17-0082 |
| Popis: | Objective. Many patients with type 2 diabetes do not reach glycemic goals despite basal insulin treatment. This study assessed the achievement of a target A1C Methods. This was a retrospective analysis of pooled randomized controlled trial (RCT) data, from 11 24-week studies of patients initiating basal insulin performed between 2000 and 2005 and of outpatient electronic medical record (EMR) data from the General Electric Centricity database for insulin-naive patients initiating basal insulin between 2005 and 2012. Baseline characteristics stratified by target A1C and fasting plasma glucose (FPG) attainment were compared descriptively. Results. In the RCT dataset, 49.0% of patients failed to achieve the target A1C at 6 months versus 72.4% and 72.9% at 6 and 12 months in the EMR dataset, respectively. Despite this, in the RCT dataset, 79.4% of patients achieved the target A1C and/or an FPG 7.0% had a longer diabetes duration and were more likely to be female, nonwhite, and self-funding or covered by Medicaid. Among patients with an A1C >7.0%, more RCT patients (58.0%) had an FPG Conclusion. Unmet needs remain after basal insulin initiation, particularly in real-world settings, where many patients require further insulin titration. In both populations, patients failing to achieve the target A1C despite attaining an FPG |
| Databáze: | OpenAIRE |
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