THE LONG-TERM INTERNATIONAL NON-INTERVENTIONAL STUDY IN PEOPLE WITH TYPE 2 DIABETES TREATED WITH INSULIN. ANALYSIS OF BASELINE OF UKRAINIAN POPULATION (CREDIT — Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy)
Keywords:CREDIT study, type 2 diabetes mellitus, insulin therapy, glycemic control, oral antidiabetic medicine
In this long-term international non-interventional study we performed analyses of baseline data from the Ukrainian population of DM type 2 patients, enrolled in the CREDIT study (n = 149), who were treated with insulin whatever the regimen for more than 1 month and less than 6 months prior the study entry. Baseline demographic characteristics of subjects at insulin initiation were the following: age (mean ± SD) 57.7 ± 8.9 years ranging from 37 to 99; 54.4 % were women and 45.6 % men. Average duration of diabetes was 7.5 ± 5.3 years ranging from 0 to 27 years; 37.6 % of subjects (n = 56) had a duration of their diabetes from 5 to 10 years. Body mass index was 30.2 ± 5.2 kg/m2 . Most recent HbA1c test either within the last year or not more than 1 month after insulin initiation was 10.1 ± 2.2 % (n=146), and a value of HbA1c > 10.0 % was found in 43.8 % subjects (n = 64). Average FBG was 222.3 ± 64.3 mg/dL, and FBG > 100 mg/dL was found in 99,3 % (n = 144) of the subjects. PPG was recorded in 142 subjects and was on average 259.7 ± 69.2 mg/dL. Treatment regimens at insulin initiation were: basal insulin alone in 53.0 % (n = 79) of subjects, basal+short acting insulin in 16.8 % of subjects, premix insulin alone in 26.9 % of subjects, short acting insulin alone in 2.0 % and other in 1.3 % of subjects. Before insulin initiation, 36.2 % of subjects (n = 54) received 1 antidiabetic medicine except insulin; 53.0 % of subjects (n = 79) had bitherapy; no treatments — in 8.1 % (n = 12). Insulin was initiated in 46.2 % of patients treated with biguanides and in 43.4 % of patients treated with sulfonylureas. Basal insulin regimen had been initiated in patients with an HbA1c of 10.1 ± 2.0 %, a FBG of 217.5 ± 62.8 mg/dL, a PPG of 254.6 ± 65.8 mg/dL (a duration of diabetes — 7.7 ± 5.6 years). Basal insulin had been initiated with a once daily injection in 78.5 % of subjects and mainly at breakfast (69.4 %); daily dose of basal insulin alone was 22.6 ± 13.5 IU. Thus, CREDIT baseline data shows that the reallife management of diabetes in Ukraine does not provide
satisfactory glycemic control in people with type 2 diabetes, due to the delay of insulin initiation. At the time of insulin initiation HbA1c is much higher than it is recommended by ADA/EASD Consensus Algorithm and Ukrainian Local Guidelines.
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