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The effectiveness of insulin initiation regimens in patients with type 2 diabetes mellitus: a large national medical records review study comparing a basal insulin analogue to premixed insulin.
Curr Med Res Opin 2007; 23(12):3017-23CM

Abstract

OBJECTIVES

The objective of the study was to compare the level of HbA(1c) reduction between a once-daily basal insulin analogue (glargine, GLG) and two twice-daily premixed insulin analogue formulations (premixed insulin lispro 75/25, PIL; premixed human insulin 70/30, PHI) in patients with type 2 diabetes mellitus (T2DM) initiating insulin therapy.

RESEARCH DESIGN AND METHODS

Data were extracted from a US national medical records database for this retrospective, 18-month, observational, cohort study. Patients with T2DM were initiated on GLG (n = 3624), PIL (n = 895) or PHI (n = 3647). A combined premixed insulin group (CPI; n = 4542) was formed for data analyses. Propensity score methods were used to adjust for 19 baseline characteristics.

MAIN OUTCOME MEASURES

Adjusted and unadjusted reductions in HbA(1c) at six time points post-insulin initiation for a period of 18 months.

RESULTS

Reductions in mean HbA(1c) relative to baseline were demonstrated by all cohorts for all treatment periods. After adjusting for baseline differences, the CPI cohort consistently demonstrated greater reductions in HbA(1c) (0.04-0.14%; p < 0.05), compared to the GLG cohort. The PIL cohort consistently demonstrated the greatest reductions in HbA(1c) (0.26-0.65%; p < 0.05), compared to the GLG cohort.

LIMITATIONS

Retrospective study design and vulnerabilities to patient drop-outs.

CONCLUSIONS

In clinical practice settings, greater reductions in HbA(1c) were found in patients with premixed insulin than with a basal insulin analogue with the greatest reduction observed with premixed insulin lispro 75/25, confirming the observations of randomized, controlled trials.

Authors+Show Affiliations

Kailo Research Group, Indianapolis, IN, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17961295

Citation

Sun, Peter, et al. "The Effectiveness of Insulin Initiation Regimens in Patients With Type 2 Diabetes Mellitus: a Large National Medical Records Review Study Comparing a Basal Insulin Analogue to Premixed Insulin." Current Medical Research and Opinion, vol. 23, no. 12, 2007, pp. 3017-23.
Sun P, Wang R, Jacober S. The effectiveness of insulin initiation regimens in patients with type 2 diabetes mellitus: a large national medical records review study comparing a basal insulin analogue to premixed insulin. Curr Med Res Opin. 2007;23(12):3017-23.
Sun, P., Wang, R., & Jacober, S. (2007). The effectiveness of insulin initiation regimens in patients with type 2 diabetes mellitus: a large national medical records review study comparing a basal insulin analogue to premixed insulin. Current Medical Research and Opinion, 23(12), pp. 3017-23.
Sun P, Wang R, Jacober S. The Effectiveness of Insulin Initiation Regimens in Patients With Type 2 Diabetes Mellitus: a Large National Medical Records Review Study Comparing a Basal Insulin Analogue to Premixed Insulin. Curr Med Res Opin. 2007;23(12):3017-23. PubMed PMID: 17961295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effectiveness of insulin initiation regimens in patients with type 2 diabetes mellitus: a large national medical records review study comparing a basal insulin analogue to premixed insulin. AU - Sun,Peter, AU - Wang,Ruoping, AU - Jacober,Scott, PY - 2007/10/27/pubmed PY - 2008/2/23/medline PY - 2007/10/27/entrez SP - 3017 EP - 23 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 23 IS - 12 N2 - OBJECTIVES: The objective of the study was to compare the level of HbA(1c) reduction between a once-daily basal insulin analogue (glargine, GLG) and two twice-daily premixed insulin analogue formulations (premixed insulin lispro 75/25, PIL; premixed human insulin 70/30, PHI) in patients with type 2 diabetes mellitus (T2DM) initiating insulin therapy. RESEARCH DESIGN AND METHODS: Data were extracted from a US national medical records database for this retrospective, 18-month, observational, cohort study. Patients with T2DM were initiated on GLG (n = 3624), PIL (n = 895) or PHI (n = 3647). A combined premixed insulin group (CPI; n = 4542) was formed for data analyses. Propensity score methods were used to adjust for 19 baseline characteristics. MAIN OUTCOME MEASURES: Adjusted and unadjusted reductions in HbA(1c) at six time points post-insulin initiation for a period of 18 months. RESULTS: Reductions in mean HbA(1c) relative to baseline were demonstrated by all cohorts for all treatment periods. After adjusting for baseline differences, the CPI cohort consistently demonstrated greater reductions in HbA(1c) (0.04-0.14%; p < 0.05), compared to the GLG cohort. The PIL cohort consistently demonstrated the greatest reductions in HbA(1c) (0.26-0.65%; p < 0.05), compared to the GLG cohort. LIMITATIONS: Retrospective study design and vulnerabilities to patient drop-outs. CONCLUSIONS: In clinical practice settings, greater reductions in HbA(1c) were found in patients with premixed insulin than with a basal insulin analogue with the greatest reduction observed with premixed insulin lispro 75/25, confirming the observations of randomized, controlled trials. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/17961295/The_effectiveness_of_insulin_initiation_regimens_in_patients_with_type_2_diabetes_mellitus:_a_large_national_medical_records_review_study_comparing_a_basal_insulin_analogue_to_premixed_insulin_ L2 - http://www.tandfonline.com/doi/full/10.1185/030079907X242845 DB - PRIME DP - Unbound Medicine ER -