Effectiveness of insulin glargine in type 2 diabetes mellitus patients failing glycaemic control with premixed insulin: Adriatic countries data meta-analysis.
OBJECTIVE
Type 2 diabetes mellitus (T2DM) is a progressive disease, often requiring exogenous insulin therapy and treatment intensification. Despite new therapies, most patients do not reach the recommended HbA1c targets, among them a significant proportion of patients on premixed insulins. The aim was to summarize published data in Adriatic countries on effectiveness of insulin glargine based therapy in type 2 diabetic patients suboptimally controlled on premix insulin.


METHODS
A meta-analysis was carried out in major medical databases up to April 2014, focusing on Adriatic region. We searched observational studies with duration of at least 6 months, evaluating effectiveness and safety of insulin glargine (IGlar), in combination with OAD or bolus insulin in patients with T2 failing premixed insulin therapy. Outcomes included values of HbA1c, fasting blood glucose and two hours post-prandial glucose concentration as well as changes in body mass index after at least 6 months of study duration.


RESULTS
Three prospective, observational, multicentric trials (698 patients in total) were included. The basal bolus regimen with glargine significantly reduced HbA1c (Mean Difference, MD=2.27, CI [1.76, 2.78]), fasting glucose (MD=5.15, CI [4.86, 5.44]) and 2-hours postprandial glucose concentration (MD=6.94, CI [6.53, 7.34]). No significant changes were found in BMI after switching from premixes to IGlar based treatment.


CONCLUSIONS
Insulin glargine based therapy following premix failure is efficacious and safe option of type 2 diabetes treatment intensification.
Department of Endocrinology, Diabetes and Metabolism, University Hospital Centre Sestre Milosrdnice, Vinogradska 29, 10000, Zagreb, Croatia. maja.cigrovskiberkovic@gmail.com.
Maja
M
Cigrovski Berkovic
Diabetes and Metabolic Disorders, University Clinic of Endocrinology, Vodnjanska 17, 1000, Skopje, Macedonia.
Goran
G
Petrovski
Sanofi, Zagreb, Croatia.
Natasa
N
Grulovic
D001786:Blood Glucose / Q000378:metabolism; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005061:Europe, Eastern; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000069036:Insulin Glargine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D015337:Multicenter Studies as Topic; D064887:Observational Studies as Topic
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine
Adriatic; Insulin glargine; Premixed insulin; Type 2 diabetes mellitus