title: Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT).
abstract: BACKGROUND
  The aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c) <7% by the end of 24 weeks of treatment in routine clinical practice.
  
  
  METHODS
  This study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24.
  
  
  RESULTS
  Seven hundred and twenty-five people with T2DM (63% female) including both insulin naïve and prior insulin users were recruited in this study. The mean age of the participants was 54.2±11.2 years, and the mean HbA1c level was 8.88%±0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c ≤7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly.
  
  
  CONCLUSIONS
  Treatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile.
authors.affiliation: Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. khamseh.m@iums.ac.ir.
authors.forename: Mohammad Ebrahim
authors.identifier: http://orcid.org/0000-0003-4313-8440
authors.initials: ME
authors.lastname: Khamseh
authors.affiliation: Endocrinology and Metabolism Research Center, Institute of Basic and Clinic Physiology Science and Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Yousefzadeh
authors.affiliation: Department of Internal Medicine, Lolagar Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Banazadeh
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Islamic Azad University, Mashhad Medical Branch, Mashhad, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Ghareh
keywords: Diabetes mellitus, type 2; Hemoglobin A, glycosylated; Insulin glargine