title: Results from the UK cohort of SOLVE: providing insights into the timing of insulin initiation in people with poorly controlled type 2 diabetes in routine clinical practice.
abstract: OBJECTIVE
  SOLVE was a large observational study of more than 17,000 insulin-naïve patients with type 2 diabetes, investigating basal insulin analogue initiation in a primary care setting across a diverse geographical area. The current analysis aimed to compare and contrast the results of the UK cohort with the previously published global population results.
  
  
  METHODS
  This analysis compares the UK cohort of SOLVE (n=761) with the global population (n=17,374). Patients eligible for the study were those for whom a clinical decision had been made to initiate treatment with a basal insulin analogue once daily as an add-on to existing OAD therapy.
  
  
  RESULTS
  The UK cohort had a higher baseline HbA1c compared to the global population of SOLVE (9.8% vs. 8.9%, respectively) despite a shorter duration of disease, indicating that strict glycaemic targets set by international organisations are not being achieved in the UK. Following 24 weeks' treatment with insulin detemir, patients in the UK achieved a reduction in HbA1c of -1.3%, the same as the reduction achieved in the global population; however, a higher dose of insulin detemir was required in the UK than in the global population.
  
  
  CONCLUSIONS
  Findings from the UK cohort of SOLVE show that it is possible to improve glycaemic control and reduce HbA1c in patients previously uncontrolled with oral antidiabetic drug therapy, in a primary setting, despite clinical inertia.
authors.affiliation: University of Leicester, Leicester, UK. Electronic address: kk22@leicester.ac.uk.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.affiliation: Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Jiten
authors.initials: J
authors.lastname: Vora
authors.affiliation: University Hospitals of Leicester, Leicester, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Davies
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D019983:Guideline Adherence; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Clinical inertia; Insulin detemir; NICE; SOLVE; Type 2 diabetes