title: Glycemic control and adherence to basal insulin therapy in Taiwanese patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The aim of the present study was to assess the glycemic control, adherence and treatment satisfaction in a real-world setting with basal insulin therapy in type 2 diabetes patients in Taiwan.
  
  
  METHODS
  This was a multicenter, prospective, observational registry. A total of 836 patients with type 2 diabetes taking oral antidiabetic drugs with glycated hemoglobin (HbA1c) >7% entered the study. Basal insulin was given for 24 weeks. All treatment choices and medical instructions were at the physician's discretion to reflect real-life practice.
  
  
  RESULTS
  After 24-week treatment, 11.7% of patients reached set HbA1c goals without severe hypoglycemia (primary effectiveness end-point). HbA1c and fasting blood glucose were significantly decreased from (mean ± SD) 10.1 ± 1.9% to 8.7 ± 1.7% (-1.4 ± 2.1%, P < 0.0001) and from 230.6 ± 68.8 mg/dL to 159.1 ± 55.6 mg/dL (-67.4 ± 72.3 mg/dL, P < 0.0001), respectively. Patients received insulin therapy at a frequency of nearly one shot per day on average, whereas self-monitoring of blood glucose was carried out approximately four times a week. Hypoglycemia was reported by 11.4% of patients, and only 0.7% of patients experienced severe hypoglycemia. Slight changes in weight (0.7 ± 2.4 kg) and a low incidence of adverse drug reactions (0.4%) were also noted. The score of 7-point treatment satisfaction rated by patients was significantly improved by 1.9 ± 1.7 (P < 0.0001).
  
  
  CONCLUSIONS
  Basal insulin therapy was associated with a decrease in HbA1c and fasting blood glucose, and an improved treatment satisfaction. Most patients complied with physicians' instructions. The treatment was generally well tolerated by patients with type 2 diabetes, but findings pointed out the need to reinforce the early and appropriate uptitration to achieve treatment targets.
authors.affiliation: Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.|Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.|Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan.
authors.forename: Ming-Nan
authors.initials: MN
authors.lastname: Chien
authors.affiliation: Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Hung
authors.affiliation: Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Changhua County, Taiwan.
authors.forename: Shu-Yi
authors.initials: SY
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Kuei Shan Hsiang, Taoyuan County, Taiwan.
authors.forename: Wen-Tsung
authors.initials: WT
authors.lastname: Lu
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Ching-Ling
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Antai Medical Care Cooperation Antai Tian-Sheng Memorial Hospital, Donggang Township, Pingtung County, Taiwan.
authors.forename: Tze-Pao
authors.initials: TP
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, Min-Sheng Hospital, Taoyuan County, Taiwan.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
authors.affiliation: Department of Medical Imaging and Radiological Sciences, Division of Cardiology, I-Shou University, Dashu District, Kaohsiung, Taiwan.|Department of Internal Medicine, E-Da Hospital, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan.
authors.forename: Wei-Kung
authors.initials: WK
authors.lastname: Tseng
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ta-Jen
authors.initials: TJ
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital, Putzu City, Chiayi County, Taiwan.
authors.forename: Cheng
authors.initials: C
authors.lastname: Ho
authors.affiliation: Department of Internal Medicine, Jen-Ai Hospital-Dali, Dali, Taichung, Taiwan.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Lin
authors.affiliation: Sanofi Taiwan, Taipei, Taiwan.
authors.forename: Bill
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. leeming@ntu.edu.tw.
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Insulin therapy; Observational study; Type 2 diabetes mellitus