title: Glycosylated hemoglobin level and number of oral antidiabetic drugs predict whether or not glycemic target is achieved in insulin-requiring type 2 diabetes.
abstract: OBJECTIVE
  Factors predicting success (glycosylated hemoglobin (A1C)<7%) with insulin therapy in patients with insulin-requiring type 2 diabetes need to be identified.
  
  
  METHODS
  A retrospective, multi-center, observational study was conducted for outpatients with oral antidiabetic drug (OAD)-treated type 2 diabetes whose A1C levels remained above 7%. Patients were begun on basal insulin between January 2005 and December 2006. Biochemical variables and demographic data were collected before and after 52 weeks of insulin therapy.
  
  
  RESULTS
  A total of 565 patients (age, 60.4±11.9 years; A1C levels, 10.11 ±1.81%; duration of diabetes, 11.5±6.8 years) were studied. By study end, 63 patients (11.2%) had achieved the glycemic goal (A1C<7%). The glycemic goal attainment rate was only 9.1% in patients with A1C>8.8% and who were taking >2 OADs at baseline. The highest rate (32.7%) of successful glycemic control was observed in the group of patients with A1C ≤ 8.8% and who used ≤ 2 OADs at baseline.
  
  
  CONCLUSIONS
  Insulin-naïve diabetic patients with A1C>8.8%, especially those who are taking >2 OADs, have small chance to achieve good glycemic control with adding only basal insulin therapy.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shi-Dou
authors.initials: SD
authors.lastname: Lin
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shih-Tzer
authors.initials: ST
authors.lastname: Tsai
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shih-Te
authors.initials: ST
authors.lastname: Tu
authors.affiliation: Department of Medicine, Cardinal Tien Hospital, New Taipei city, Taiwan; The Graduate Institute of Applied Science and Engineering, Fu-Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Ching-Chieh
authors.initials: CC
authors.lastname: Su
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Jung-Fu
authors.initials: JF
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan; Department of Business Administration, National Chung Cheng University, Tainan, Taiwan.
authors.forename: Chieh-Hsiang
authors.initials: CH
authors.lastname: Lu
authors.affiliation: Department of Endocrinology and Metabolism, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Yu Neng-Chun Diabetes Clinic, I-Lan County, Taiwan.
authors.forename: Neng-Chun
authors.initials: NC
authors.lastname: Yu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Shang-Ren
authors.initials: SR
authors.lastname: Hsu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; College of Medicine, Chung Shan Medical University, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. Electronic address: 146446@cch.org.tw.
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Hsieh
mesh_terms: D000284:Administration, Oral; 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*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Glycemic target; Insulin therapy; Predictors; Type 2 diabetes