Effectiveness of therapy with basal insulin analogs to improve glycemic control in type 2 diabetes mellitus patients poorly controlled with oral antidiabetic drugs in combination or not with NPH insulin

Objective: To determine the effectiveness of therapy with basal insulin analogs administered in poorly controlled type 2 diabetes mellitus patients switching from oral antidiabetic drugs with or without NPH insulin. Patients and methods: Observational retrospective study carried out in 250 type 2 diabetes mellitus patients who switched from oral antidiabetic drugs with or without insulin NPH to basal insulin analog, due to poor metabolic control (HbA1c >8%). Demographic data, anthropometric, laboratory parameters and treatment-related information were retrospectively extracted from patients’ medical notes at the initiation of therapy with basal insulin analog and after at least 5 months of treatment. Results: A significant reduction in HbA1c levels between baseline and month 5 (9.2±1.4% vs 7.6±1.1%; p<0.001) was obtained, with a total of 61 (24.4%) patients reaching metabolic control (HbA1c <7%). An overall non-significant change in body weight was observed between baseline to month 5 (79.8±13.2kg vs 79.5±13.1kg; p>0.05). Among those 38 subjects who received NPH insulin prior to basal insulin analog, a significant decrease in the number of patients with hypoglycemic episodes after at least 5 months of treatment was seen (16 vs 5; p<0.01). Conclusions: Treatment with long-acting basal insulin analogs improved glycemic control in type 2 diabetes mellitus patients poorly controlled with oral antidiabetic drugs in combination or not with NPH insulin. Moreover, this improvement was produced with a significant reduction in the number of symptomatic hypoglycemic episodes and without a significant increase in body weight.