title: Exploring the characteristics of suboptimally controlled patients after 24weeks of basal insulin treatment: An individualized approach to intensification.
abstract: OBJECTIVE
  To identify characteristics of suboptimally controlled patients with type 2 diabetes (T2DM) on basal insulin treatment who may benefit from intensive titration or further intensification of treatment.
  
  
  METHODS
  A post hoc analysis of SOLVE: a 24-week, international, observational study conducted in 17,374 patients with T2DM inadequately controlled on oral antidiabetic drugs (OADs) started on once-daily insulin detemir. Patients were divided into two groups based on whether they achieved HbA1c<7.0% (<53.0mmol/mol) or not at final visit.
  
  
  RESULTS
  Suboptimal glycemic control (HbA1c⩾7.0 [⩾53.0mmol/mol]) was independently associated with several baseline characteristics including higher baseline HbA1c(odds ratio [95% confidence interval]: 1.56 [1.50;1.62]; p<0.0001) and body mass index (BMI) (1.03 [1.02;1.04]; p<0.0001), longer duration of diabetes (5-10years: 1.44 [1.25;1.66]; >10years: 1.44 [1.17;1.77]; p<0.0001), and greater number of OADs (two OADs: 1.27 [1.12;1.44]; >2 OADs: 1.38 [1.14;1.66]; p=0.0003). Overall reporting of hypoglycemia was low; fewer patients with HbA1c⩾7.0% (⩾53.0mmol/mol) reported hypoglycemic events compared with patients with HbA1c<7.0% (9.8% vs. 12.5%, respectively; p<0.001).
  
  
  CONCLUSIONS
  Baseline characteristics related to severity of disease were strongly associated with suboptimal glycemic control in patients with T2DM receiving basal insulin. These factors may help clinicians in identifying patients who may require an individualized approach to titration or intensification of treatment.
  
  
  BACKGROUND
  NCT00740519.
authors.affiliation: Diabetes Research Centre, University of Leicester, Leicester, UK. Electronic address: kk22@le.ac.uk.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Cerrahpasa Medical School, Istanbul University, 34363 Istanbul, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Damci
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: Lise Lotte
authors.initials: LL
authors.lastname: Husemoen
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: Vinay
authors.initials: V
authors.lastname: Babu
authors.affiliation: Center for Diabetes and Metabolism, m&i-Fachklinik Bad Heilbrunn, Wörnerweg 30, Bad Heilbrunn 83670, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Liebl
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting
keywords: Basal insulin detemir; HbA1c; Hypoglycemia; Type 2 diabetes mellitus