title: First insulinization with basal insulin in patients with Type 2 diabetes in a real-world setting in Asia.
abstract: BACKGROUND
  The First Basal Insulin Evaluation (FINE) Asia study is a multinational, prospective, observational study of insulin-naïve Type 2 diabetes mellitus (T2DM) patients in Asia, uncontrolled (A1c ≥ 8%) on oral hypoglycemic agents, designed to evaluate the impact of basal insulin initiation.
  
  
  METHODS
  Basal insulin was initiated with or without concomitant oral therapy and doses were adjusted individually. All treatment choices, including the decision to initiate insulin, were at the physician's discretion to reflect real-life practice.
  
  
  RESULTS
  Patients (n=2679) from 11 Asian countries were enrolled (mean [±SD] duration of diabetes 9.3±6.5 years; weight 68.1±12.7 kg; A1c 9.8 ± 1.6%). After 6 months of basal insulin (NPH insulin, insulin glargine, or insulin detemir), A1c decreased to 7.7±1.4%; 33.7% patients reached A1c <7%. Fasting blood glucose (FBG) decreased from 11.7±3.6 to 7.2±2.5 mmol/L and 36.8% of patients reached FBG <6.1 mmol/L. The mean daily insulin dose prescribed increased marginally from 0.18 to 0.23 U/kg per day at baseline to 0.22-0.24 U/kg per day at Month 6. Mean changes in body weight and reported rates of hypoglycemia were low over the duration of the study.
  
  
  CONCLUSIONS
  Initiation of insulin therapy is still being delayed by approximately 9 years, resulting in many Asian patients developing severe hyperglycemia. Initiating insulin treatment with basal insulin was effective and safe in Asian T2DM patients in a real-world setting, but insulin needs may differ from those in Western countries.
authors.affiliation: Taipei Veterans General Hospital, No. 201 Sec. 2 Shipai Road, Taipei, Taiwan. tsaist@vghtpe.gov.tw
authors.forename: Shih-Tzer
authors.initials: ST
authors.lastname: Tsai
authors.forename: Faruque
authors.initials: F
authors.lastname: Pathan
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.forename: Vincent Tok Fai
authors.initials: VT
authors.lastname: Yeung
authors.forename: Manoj
authors.initials: M
authors.lastname: Chadha
authors.forename: Ketut
authors.initials: K
authors.lastname: Suastika
authors.forename: Hyun Shik
authors.initials: HS
authors.lastname: Son
authors.forename: Kevin Eng Kiat
authors.initials: KE
authors.lastname: Tan
authors.forename: Yupin
authors.initials: Y
authors.lastname: Benjasuratwong
authors.forename: Thy Khue
authors.initials: TK
authors.lastname: Nguyen
authors.forename: Farrukh
authors.initials: F
authors.lastname: Iqbal
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001208:Asia; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology; D004305:Dose-Response Relationship, Drug; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin