Insulin initiation in type 2 diabetic patients admitted in hospital in France and follow-up at 1 year.
OBJECTIVE
The IDAHO 2 epidemiological survey was conducted in departments of diabetology in insulin-naïve type 2 diabetics for whom insulin was initiated. The objective was to assess the patients' profile, the treatments proposed during hospital stay and after one year.


RESULTS
797 patients were analysed. Their characteristics were: age 64+/-12 years, 49% males, weight: 78+/-17 kg, BMI: 29+/-6 kg/m2, diabetes duration 11 years, prevalence of complications: 68%, fasting blood glucose 13+/-6 mmol/l, HbA1c: 10+/-2.2%; treatment prior to insulin comprised: at least 2 OHA: 71% of cases, one: 21%, no OAD: 8%. At hospital discharge, 54% of the patients used basal insulin. After 1 year, 670 continued on insulin. The insulin initiation was accompanied by a decrease in the FBG level (baseline: 13+/-6 mmol/l; final: 8.5+/-2.75 mmol/l; P<0.0001) and a HbA1c improvement (baseline: 10+/-2.2%; final: 7.9+/-1.4%; P<0.0001). This was observed du-ring the first 6 months (HbA1c: 7.8%, P<0.0001 versus baseline). 80% of the patients remained on the same insulin regimen after 1 year: 35% had 1 injection/day, 44% had 2, 12% had 3 and 9% had a complex regimen. The weight gain, the final daily dose and hypoglycaemias increased with the number of injections. The mean daily insulin dose was 33 U/day (24 U with 1 injection/day).


CONCLUSIONS
The IDAHO study shows that insulin is effective in type 2 diabetics however, management is inadequate with insulin therapy being initiated too late and at doses which are low after one year.
Raccah
D
D
Service de Nutrition, Endocrinologie et Maladies Métaboliques, Hôpital Sainte-Marguerite, Marseille, France.
Hanaire-Broutin
H
H
Sert-Langeron
C
C
Brin
S
S
Chabrier
G
G
Fontaine
P M
PM
Rodier
M
M
Vaur
L
L
Eschwege
E
E
D000368:Aged; D015992:Body Mass Index; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005602:France; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients; D007328:Insulin / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged
D007004:Hypoglycemic Agents; D007328:Insulin