Concomitant Oral Antihyperglycemic Agent Use and Associated Treatment Outcomes After Initiation of Insulin Therapy |
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| Institution: | 1. University of Michigan, Ann Arbor, Michigan;2. University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;3. University of Hawaii at Manoa, Honolulu, Hawaii;4. Ohio State University Medical Center, Columbus, Ohio;5. Lilly USA, LLC; Indianapolis, Indiana;1. University of Colorado Denver, Aurora, Colorado;2. Sanofi US, Inc., Bridgewater, New Jersey;3. Medpace, Cincinnati, Ohio.;4. Scripps Clinic, La Jolla, California.;1. Department of Physical Medicine and Rehabilitation, University of Texas Medical School at Houston, and TIRR Memorial Hermann Research Center, Houston, TX, USA\n;2. Guangdong Work Injury Rehabilitation Center, Guangzhou, Guangdong Province, China |
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| Abstract: | ObjectiveTo compare outcomes in patients with type 2 diabetes initiating insulin lispro mix 75/25 (75% insulin lispro protamine suspension and 25% lispro) or insulin glargine therapy, stratified by baseline oral antihyperglycemic agent (OHA) use.MethodsWe performed a post hoc analysis of 6-month data from the DURABLE clinical trial, which enrolled patients with hemoglobin A1c (A1C) levels > 7.0% treated with 2 or more OHAs (metformin, sulfonylurea, and thiazolidinedione), and randomly assigned them to treatment with twice-daily insulin lispro 75/25 or oncedaily glargine.ResultsIn both insulin treatment groups, metformin/ thiazolidinedione-treated patients had significantly greater improvement in A1C levels (-2.19% to -2.36%), lower end point A1C values, and lower rates of occurrence of hypoglycemia in comparison with metformin/sulfonylurea-treated patients (all P < .05). Patients treated with sulfonylurea/thiazolidinedione or metformin/sulfonylurea/thiazolidinedione did not differ significantly from metformin/sulfonylurea-treated patients in A1C change (-1.56% to -1.84%) or rates of occurrence of hypoglycemia.ConclusionIn these post hoc analyses, patients with type 2 diabetes initiating premixed or basal insulin therapy and treated concomitantly with the OHA combination of metformin/thiazolidinedione at baseline demonstrated significantly greater A1C improvement with less hypoglycemia in comparison with patients treated with metformin/ sulfonylurea. (Endocr Pract. 2011;17:563-567) |
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