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Title: Exploring the characteristics of suboptimally controlled patients after 24 weeks of basal insulin treatment: An individualized approach to intensification
Authors: Khunti, Kamlesh
Damci, Taner
Husemoen, Lise Lotte
Babu, Vinay
Liebl, Andreas
First Published: 9-Dec-2016
Publisher: Elsevier for International Diabetes Federation
Citation: Diabetes Research and Clinical Practice, 2017, 123, pp. 209-217
Abstract: AIM: 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. TRIAL REGISTRATION: NCT00740519.
DOI Link: 10.1016/j.diabres.2016.11.028
eISSN: 1872-8227
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2016. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License (, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Appears in Collections:Published Articles, Dept. of Health Sciences

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