title: Effectiveness of basal-supported oral therapy (BOT) using insulin glargine in patients with poorly controlled type 2 diabetes.
abstract: OBJECTIVE
  To determine the clinical usefulness of basal-supported oral therapy (BOT) using insulin glargine in Japanese patients with type 2 diabetes.
  
  
  METHODS
  We compared HbA1c levels, body weight, and insulin doses before the introduction of BOT and in the final month of the observation period in 122 patients with type 2 diabetes who received BOT with insulin glargine between October 2007 and July 2009. To exclude the possible effects of seasonal changes in glycemic control, 57 of the 122 patients were followed-up for one year and examined for changes in HbA1c levels, body weight, and insulin dose.
  
  
  RESULTS
  Examination of all cases (n=122) showed a significant decrease in HbA1c (before BOT: 8.7±1.8, after: 7.1±1.1%), but no significant change in body weight (before: 63.1±16.1, after: 63.8±17.0 kg). The mean observation period was 10.5±6.4 months. Insulin doses were significantly increased during the study. HbA1c levels improved significantly in patients on non-insulin-secreting drugs (biguanide, α-glucosidase inhibitor and thiazolidine derivatives) than those on insulin-secreting drugs (SU agents and glinides).
  
  
  CONCLUSIONS
  BOT with insulin glargine is a useful strategy that can achieve good glycemic control in clinical practice without causing serious hypoglycemia. The introduction of BOT before exhaustion of pancreatic β cells may increase its effectiveness.
authors: Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. daisuke@is.icc.u-tokai.ac.jp
authors: Daisuke
authors: D
authors: Suzuki
authors: Tomoya
authors: T
authors: Umezono
authors: Masaaki
authors: M
authors: Miyauchi
authors: Moritsugu
authors: M
authors: Kimura
authors: Naoyuki
authors: N
authors: Yamamoto
authors: Eitaro
authors: E
authors: Tanaka
authors: Yusuke
authors: Y
authors: Kuriyama
authors: Hiroki
authors: H
authors: Sato
authors: Han
authors: H
authors: Miyatake
authors: Masumi
authors: M
authors: Kondo
authors: Masao
authors: M
authors: Toyoda
authors: Masafumi
authors: M
authors: Fukagawa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000008:administration & dosage
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human