An observational, multicentre study on different insulin glargine U100 titration algorithms used in patients with type 2 diabetes in daily medical practice in Adriatic countries: The ADRESA study

Diabetes Res Clin Pract. 2019 Apr:150:144-149. doi: 10.1016/j.diabres.2019.01.001. Epub 2019 Jan 11.

Abstract

Aims: To compare the effectiveness of different titration algorithms for insulin glargine U100 used in everyday practice to achieve glycaemic targets in patients with type 2 diabetes mellitus (T2DM).

Methods: A total of 526 patients (278 in Slovenia, 248 in Croatia) with T2DM (aged ≥ 18 years) and treated with insulin glargine prior to inclusion were enrolled. Patients self-titrated insulin glargine according to physicians' guidance.

Results: Among the 524 patients included in the final analysis, the titration algorithm from the LANMET study was used most commonly (n = 368, 70.5% patients), followed by the Treat-To-Target (TTT) algorithm (n = 117, 22.4%). At the end of the study (6 months), 179 (34.3%) patients reached HbA1c ≤ 7%. There was no significant difference in the proportion of patients who reached their target HbA1c between the different algorithms at 6 months (35.6% using LANMET, 30.7% with TTT, and 32.4% with other algorithms; p = 0.611). HbA1c levels were more significantly reduced in patients using the TTT algorithm compared to LANMET (-2.31%, vs. -1.57%; p < 0.05). The proportion of patients with reported symptomatic hypoglycaemia did not differ significantly between the algorithms.

Conclusions: Continuous titration of insulin glargine U100 is a safe and efficient option for T2DM management, regardless of the titration algorithm applied.

Keywords: Glycaemic control; HbA1c; Insulin glargine; Titration algorithms; Type 2 diabetes mellitus.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Algorithms*
  • Blood Glucose / analysis
  • Croatia
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diagnostic Tests, Routine / standards*
  • Dose-Response Relationship, Drug
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemia / prevention & control
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Glargine / therapeutic use*
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / standards*
  • Prospective Studies
  • Slovenia
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin Glargine