Effect of baseline glycosylated hemoglobin a1c on glycemic control and diabetes management following initiation of once-daily insulin detemir in real-life clinical practice

Salvatore Caputo, Henning Andersen, Marcel Kaiser, Eddy Karnieli, Luigi F. Meneghini, Anne Louise Svendsen

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Objective: The SOLVE study investigate. The initiation of basal insulin in patients with type 2 diabetes on oral antidiabetic (OAD) treatment and outcomes in patients with varying levels of glycemic control at baseline.Methods: This was an observational cohort study conducted in 10 countries using insulin detemir. Data were collected at 3 clinic visits (baseline, 12-week interim, and 24-week final visit).Results: A total of 13,526 (77.9%) patients were included i. The glycosylated hemoglobin A1c (HbA1c) subset analysis. Patients were grouped according to pre-insulin HbA1c values as follows: HbA1c <7.6% (n = 2,797); HbA1c 7.6-9% (n = 5,366), and HbA1c >9% (n = 5,363). A total of 27 patients experienced serious adverse drug reactions (SADRs) and/or severe hypoglycemia (3, 10, and 11 patients with pre-insulin HbA1c <7.6%, 7.6-9.0%, and >9.0%, respectively). All patient subgroups realized improvements in HbA1c, wit. The pre-insulin HbA1c >9% subgroup havin. The largest HbA1c reduction (-2.4% versus -0.9% and -0.2% for HbA1c subgroups 7.6-9% and <7.6%, respectively). I. The total cohort (n = 17,374). The incidence of severe hypoglycemia decreased from 4 events per 100 person years to <1 event per 100 person years by final visit. The incidence of minor hypoglycemia increased from 1.6 to 1.8 events per person year.Conclusions: In this study, insulin initiation was delayed until late in disease course, and overall concordance with internationally recognized guidelines was low. The initiation of once-daily insulin detemir was associated with substantial improvements in glycemic control and was not associated with an increase in severe hypoglycemia or weight gain.

Original languageEnglish
Pages (from-to)462-470
Number of pages9
JournalEndocrine Practice
Volume19
Issue number3
DOIs
StatePublished - May 1 2013

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ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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