Glycemic effects of once-a-day rapid-acting insulin analogue addition on a basal insulin analogue in Korean subjects with poorly controlled type 2 diabetes mellitus

Eun Yeong Choe, Yong Ho Lee, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee

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8 Citations (Scopus)

Abstract

Background: The present study investigates the efficacy in glycemic control by adding once-a-day glulisine to glargine as a basal plus regimen and factors influencing glycemic control with the basal plus regimen in Korean subjects with type 2 diabetes. Methods: In the present retrospective study, subjects previously treated with the basal plus regimens for at least 6 months were reviewed. Changes in glycemic profiles and clinical parameters were evaluated. Results: A total of 87 subjects were ultimately enrolled in this study. At baseline, mean glycated hemoglobin (A1c) and glycated albumin were 8.5% (8.0% to 9.6%) and 25.2±7.6%, respectively. After treatment with the basal plus regimen, patients had significant reductions of A1c at 6 months (0.8±0.1%, P<0.001) and their postprandial glucose levels were decreased by 48.7±10.3 mg/dL (P<0.001). Multiple logistic regression showed old age (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.02 to 1.55), high initial A1c (OR, 22.21; 95% CI, 2.44 to 201.78), and lower amounts of glargine (OR, 0.85; 95% CI, 0.76 to 0.99), and glimepiride (OR, 0.23; 95% CI, 0.06 to 0.93) at baseline were independently associated with good responders whose A1c reduction was more than 0.5%. Conclusion: The authors suggest a basal plus regimen may be effective in reducing glucose levels of subjects with old age, high initial A1c, and patients on low doses of glimepiride and glargine. Despite the use of high doses of hypoglycemic agents, elderly patients with poorly-controlled diabetes are preferred for early initiation of the basal plus regimen.

Original languageEnglish
Pages (from-to)230-236
Number of pages7
JournalDiabetes and Metabolism Journal
Volume36
Issue number3
DOIs
Publication statusPublished - 2012 Jun 1

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Short-Acting Insulin
glimepiride
Type 2 Diabetes Mellitus
Odds Ratio
Confidence Intervals
Insulin
Glucose
Glycosylated Hemoglobin A
Hypoglycemic Agents
Retrospective Studies
Logistic Models
Insulin Glargine

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

@article{1a67988693c44302a4494d65423caf48,
title = "Glycemic effects of once-a-day rapid-acting insulin analogue addition on a basal insulin analogue in Korean subjects with poorly controlled type 2 diabetes mellitus",
abstract = "Background: The present study investigates the efficacy in glycemic control by adding once-a-day glulisine to glargine as a basal plus regimen and factors influencing glycemic control with the basal plus regimen in Korean subjects with type 2 diabetes. Methods: In the present retrospective study, subjects previously treated with the basal plus regimens for at least 6 months were reviewed. Changes in glycemic profiles and clinical parameters were evaluated. Results: A total of 87 subjects were ultimately enrolled in this study. At baseline, mean glycated hemoglobin (A1c) and glycated albumin were 8.5{\%} (8.0{\%} to 9.6{\%}) and 25.2±7.6{\%}, respectively. After treatment with the basal plus regimen, patients had significant reductions of A1c at 6 months (0.8±0.1{\%}, P<0.001) and their postprandial glucose levels were decreased by 48.7±10.3 mg/dL (P<0.001). Multiple logistic regression showed old age (odds ratio [OR], 1.25; 95{\%} confidence interval [CI], 1.02 to 1.55), high initial A1c (OR, 22.21; 95{\%} CI, 2.44 to 201.78), and lower amounts of glargine (OR, 0.85; 95{\%} CI, 0.76 to 0.99), and glimepiride (OR, 0.23; 95{\%} CI, 0.06 to 0.93) at baseline were independently associated with good responders whose A1c reduction was more than 0.5{\%}. Conclusion: The authors suggest a basal plus regimen may be effective in reducing glucose levels of subjects with old age, high initial A1c, and patients on low doses of glimepiride and glargine. Despite the use of high doses of hypoglycemic agents, elderly patients with poorly-controlled diabetes are preferred for early initiation of the basal plus regimen.",
author = "Choe, {Eun Yeong} and Lee, {Yong Ho} and Lee, {Byung Wan} and Kang, {Eun Seok} and Cha, {Bong Soo} and Lee, {Hyun Chul}",
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Glycemic effects of once-a-day rapid-acting insulin analogue addition on a basal insulin analogue in Korean subjects with poorly controlled type 2 diabetes mellitus. / Choe, Eun Yeong; Lee, Yong Ho; Lee, Byung Wan; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul.

In: Diabetes and Metabolism Journal, Vol. 36, No. 3, 01.06.2012, p. 230-236.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Glycemic effects of once-a-day rapid-acting insulin analogue addition on a basal insulin analogue in Korean subjects with poorly controlled type 2 diabetes mellitus

AU - Choe, Eun Yeong

AU - Lee, Yong Ho

AU - Lee, Byung Wan

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lee, Hyun Chul

PY - 2012/6/1

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N2 - Background: The present study investigates the efficacy in glycemic control by adding once-a-day glulisine to glargine as a basal plus regimen and factors influencing glycemic control with the basal plus regimen in Korean subjects with type 2 diabetes. Methods: In the present retrospective study, subjects previously treated with the basal plus regimens for at least 6 months were reviewed. Changes in glycemic profiles and clinical parameters were evaluated. Results: A total of 87 subjects were ultimately enrolled in this study. At baseline, mean glycated hemoglobin (A1c) and glycated albumin were 8.5% (8.0% to 9.6%) and 25.2±7.6%, respectively. After treatment with the basal plus regimen, patients had significant reductions of A1c at 6 months (0.8±0.1%, P<0.001) and their postprandial glucose levels were decreased by 48.7±10.3 mg/dL (P<0.001). Multiple logistic regression showed old age (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.02 to 1.55), high initial A1c (OR, 22.21; 95% CI, 2.44 to 201.78), and lower amounts of glargine (OR, 0.85; 95% CI, 0.76 to 0.99), and glimepiride (OR, 0.23; 95% CI, 0.06 to 0.93) at baseline were independently associated with good responders whose A1c reduction was more than 0.5%. Conclusion: The authors suggest a basal plus regimen may be effective in reducing glucose levels of subjects with old age, high initial A1c, and patients on low doses of glimepiride and glargine. Despite the use of high doses of hypoglycemic agents, elderly patients with poorly-controlled diabetes are preferred for early initiation of the basal plus regimen.

AB - Background: The present study investigates the efficacy in glycemic control by adding once-a-day glulisine to glargine as a basal plus regimen and factors influencing glycemic control with the basal plus regimen in Korean subjects with type 2 diabetes. Methods: In the present retrospective study, subjects previously treated with the basal plus regimens for at least 6 months were reviewed. Changes in glycemic profiles and clinical parameters were evaluated. Results: A total of 87 subjects were ultimately enrolled in this study. At baseline, mean glycated hemoglobin (A1c) and glycated albumin were 8.5% (8.0% to 9.6%) and 25.2±7.6%, respectively. After treatment with the basal plus regimen, patients had significant reductions of A1c at 6 months (0.8±0.1%, P<0.001) and their postprandial glucose levels were decreased by 48.7±10.3 mg/dL (P<0.001). Multiple logistic regression showed old age (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.02 to 1.55), high initial A1c (OR, 22.21; 95% CI, 2.44 to 201.78), and lower amounts of glargine (OR, 0.85; 95% CI, 0.76 to 0.99), and glimepiride (OR, 0.23; 95% CI, 0.06 to 0.93) at baseline were independently associated with good responders whose A1c reduction was more than 0.5%. Conclusion: The authors suggest a basal plus regimen may be effective in reducing glucose levels of subjects with old age, high initial A1c, and patients on low doses of glimepiride and glargine. Despite the use of high doses of hypoglycemic agents, elderly patients with poorly-controlled diabetes are preferred for early initiation of the basal plus regimen.

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