title: Clinical course after five years of insulin therapy in patients with type 2 diabetes in Spain: results of the EDIN study.
abstract: OBJECTIVE
  The primary study objective was to assess the proportion of patients with type 2 diabetes and an HbA1c value ≤ 6.5% from the start of insulin therapy to five years later in the outpatient setting in Spain.
  
  
  METHODS
  This was an observational, multicenter, naturalistic study with retrospective collection of clinical data. Investigators were endocrinologists or internal medicine specialists from all over Spain. During standard clinical care, patients started insulin therapy, which was continued for at least 5 years.
  
  
  RESULTS
  The clinical records of 405 patients were reviewed. The final analysis set included records from 346 patients. At baseline (start of insulin therapy), 51.2% of patients were female; mean (SD) age was 64.6 (9.0) years; body mass index, 29.8 (4-5) kg/m(2); time since diagnosis, 8.8 (6.8) years; HbA1c, 9.4% (1.5); fasting glucose, 223.7 (55.9) mg/dL; and mean 2-hour postprandial glucose, 293.6 (71.0) mg/dL. When insulin therapy was started, <1.0% of patients had an HbA1c value ≤ 6.5%. At 5 years, 10.3% of patients achieved the HbA1c goal of ≤ 6.5% (mean, 7.72%). All glucose parameters (HbA1c, fasting glucose, and 2-hour postprandial glucose) improved at 5 years as compared to values at the start of insulin therapy.
  
  
  CONCLUSIONS
  Glucose parameters improved over time in patients with type 2 diabetes in this naturalistic study. However, blood glucose control exceeded the internationally recommended target values. These results therefore suggest that there is still some margin for improvement in outpatient care in Spain.
authors.affiliation: Lilly Spain, Alcobendas, Madrid, España. Electronic address: rodriguez_angel@lilly.com.
authors.forename: Angel
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Departamento de Endocrinología y Nutrición, Hospital Universitario Son Espases, Mallorca, España.
authors.forename: Santiago
authors.initials: S
authors.lastname: Tofe
authors.affiliation: Lilly Spain, Alcobendas, Madrid, España.
authors.forename: Jesus
authors.initials: J
authors.lastname: Reviriego
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes tipo 2; España; Inicio de la insulinoterapia; Insulin therapy initiation; Observacional; Observational; Spain; Type 2 diabetes