title: Long-term glycemic control in Japanese type 2 diabetes patients after switching treatment from twice-daily premixed insulin to once daily insulin glargine.
abstract: OBJECTIVE
  To examine the clinical utility of once-daily insulin glargine, we studied the clinical course of patients who were switched to from twice-daily premixed insulin to once daily insulin glargine.
  
  
  METHODS
  The study was conducted at Tokai University hospital in 20 patients with type 2 diabetes, whose treatment regimens were switched from twice-a-day premixed insulin formulation to once-a-day insulin glargine. Changes in various clinical indexes were studied during a 3-year period after the switch. We also compared the well-controlled group (hemoglobin A1c, HbA1c, levels maintained at less than 6.9%) and poorly-controlled group (HbA1c levels at 7.4% or higher).
  
  
  RESULTS
  During the 3-year period, all patients showed significant decrease in HbA1c levels and tendency for reduced daily dose of insulin. Although both BMI and insulin dose tended to decrease in the well-controlled group, they increased in the poorly controlled group.
  
  
  CONCLUSIONS
  The findings suggest that in type 2 diabetes, once-a-day insulin glargine could be more useful than twice-a-day premixed insulin formulation. Poor adherence was observed in the poorly-controlled group, namely lack of thoroughness in self-monitoring of blood glucose and adherence to diet and exercise therapy, thus emphasizing the importance of diabetes education.
authors.affiliation: Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. umechan@is.icc.u-tokai.ac.jp
authors.forename: Tomoya
authors.initials: T
authors.lastname: Umezono
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kuriyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyauchi
authors.forename: Moritsugu
authors.initials: M
authors.lastname: Kimura
authors.forename: Eitaro
authors.initials: E
authors.lastname: Tanaka
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sato
authors.forename: Han
authors.initials: H
authors.lastname: Miyatake
authors.forename: Masumi
authors.initials: M
authors.lastname: Kondo
authors.forename: Masao
authors.initials: M
authors.lastname: Toyoda
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine