Practical implementation of ADA/EASD consensus algorithm in patients with type 2 diabetes in Pakistan

J Pak Med Assoc. 2018 Sep;68(9):1304-1309.

Abstract

Objective: To ascertain the effectiveness of implementing the American Diabetes Association/European Association for the Study of Diabetes 2009 consensus algorithm in achieving glycaemic control in patients with type 2 diabetes.

Methods: The prospective, observational, open label, product registry was conducted at 38 sites across 7 cities in Pakistan between July 2011 and February 2014. Uncontrolled type 2 diabetes patients were either initiated on or switched to insulin glargine from other basal insulin. Glycated haemoglobin and fasting blood glucose were measured at baseline, 3 and 6 months.

Results: Of the 307 patients, 166(54%) were males. At baseline, the overall mean age was 49.5 ± 8.7 years. Mean duration of diabetes was 7.1 ± 4.5 years. Both fasting blood glucose and glycated haemoglobin levels significantly reduced from baseline to 3 months to 6 months (p<0.01). At 6 months, 18(5.8%) patients reported 41 hypoglycaemic episodes of which 19(46.3%) were asymptomatic and 22(53.6%) were symptomatic. No severe hypoglycaemic episodes were reported.

Conclusions: Insulin initiation and titration as per American Diabetes Association/European Association for the Study of Diabetes guidelines helped in achieving glycaemic targets without increasing the risk of hypoglycaemia.

Keywords: Diabetes mellitus, Type 2, Glargine, Hypoglycaemia. (JPMA 68: 1304; 2018).

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Algorithms
  • Consensus
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / diagnosis
  • Hypoglycemia* / epidemiology
  • Hypoglycemia* / prevention & control
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Insulin Glargine* / administration & dosage
  • Insulin Glargine* / adverse effects
  • Male
  • Middle Aged
  • Pakistan / epidemiology
  • Practice Guidelines as Topic
  • Prospective Studies

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin Glargine