engleski

Effectiveness of insulin glargine in type 2 diabetes mellitus patients failing glycaemic control with premixed insulin: Adriatic countries data meta-analysis

Type 2 diabetes mellitus is a progressive disease, often requiring exogenous insulin therapy and treatment intensification. Despite new therapies, most patients do not reach the recommended HbA1c targets, among them a significant proportion of patients on premixed insulin. Methods: A meta- analysis was carried out in major medical databases up to April 2014, focusing on the Adriatic region. We searched observational studies with duration of at least 6 months, evaluating effectiveness and safety of insulin glargine (IGlar), in combination with OAD or bolus insulin in patients with T2 failing premixed insulin therapy. Outcomes included values of HbA1c, fasting blood glucose, and 2-h postprandial glucose concentration as well as changes in body mass index after at least 6 months of study duration. A meta-analysis was carried out in major medical databases up to April 2014, focusing on Adriatic region. Outcomes included values of HbA1c, fasting blood glucose and 2 h post-prandial glucose concentration as well as changes in body mass index after at least 6 months of study duration. Results: Three prospective, observational, multicentric trials (698 patients in total) were included. The basal-bolus regimen with glargine significantly reduced HbA1c (mean difference, MD 2.27, CI [1.76, 2.78]), fasting glucose (MD 5.15, CI [4.86, 5.44]), and 2-h postprandial glucose concentration (MD 6.94, CI [6.53, 7.34]). No significant changes were found in BMI after switching from premixes to IGlar- based treatment. Conclusion: Insulin glargine- based therapy following premix failure is efficacious and safe option of type 2 diabetes treatment intensification.

type 2 diabetes mellitus ; insulin glargine ; premix insulin ; Adriatic

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