Need to redefine the treatment paradigm Post OAD
Adults with Type 2 diabetes on OADs often struggle to achieve adequate fasting and postprandial glucose control without increasing their treatment burden:
Can a change in current practice help smooth their journey post-OAD?
They may face additional treatment burdens with their first injectable therapy
†Basal bolus, premix.
*The CNHSS project was initiated by the Chinese Diabetes Society and conducted in mainland China from April to June 2013 . The CNHSS was established to monitor glycemic control in adults with T2DM. A total of 24,266 adult T2DM patients were included, and they were divided into pure fasting hyperglycemia group (IFH, n=2674, 19.7%), pure postprandial hyperglycemia group (IPH, n=6462, 47.6%) and combined hyperglycemia group (CH, n=4444, 32.7%) according to phenotype. Accordingly, the calculated proportion of patients who were having fasting hyperglycemia is 52.4% (19.7% IFH + 32.7% CH) and who were having postprandial hyperglycemia is 80.3% (47.6% IPH + 32.7% CH). The main outcomes were diabetic retinopathy, diabetic nephropathy, and diabetic retinopathy combined with nephropathy, aiming to study the correlation between abnormal blood glucose phenotypes and microvascular complications in patients with type 2 diabetes.1 tBasal bolus, premix. The IDMPS is the largest ongoing global, cross-sectional observational study describing real-world data on patient profiles, disease management and patterns of care in people with diabetes across 27 countries across Africa, Eurasia, the Middle East and South Asia.' A retrospective cohort study i nvestigated whether clinical inertia, the failu re to intensify treatment when required, exists in Japanese clinical practice, usi ng the CoDiC® database.'*Study Design: Randomized, open-label, 48-week study compared two algorithms. Up to three injections of insu lin lispro mix 25 and/or insu lin lispro mix 50 (premix; premixed insulin lispro) or basal insulin glargine plus up to three injections of insulin lispro (basal+; glargine + insu lin lispro) were used in type 2 diabetic patients uncontrolled with oral antihyperglycemic medication and consuming<15% daily calories at breakfast. The primary objective was to test the non-inferiority in glycemic contrai with premix versus basal plus regimen based on the HbA1c at week 48.4
Abbreviations:
HbA1c: Hemoglobin A," iDegAsp: insulin degludec/insulin aspart, iGlar: lnsulin glargine, T2D: Type 2 diabetes
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References:
- Liu G, et al. Diabetes Metab Syndr Obes. 2020;13:4651-4659.
- Ramachandran A, et al. Poster presented at EASD 2019 #873. Available at: https://www.easd.org/media-centre/#!resources/unmet-medical-needs-in-people-with-type-2-diabetes-treated-by-insulin-results-from-the-internationaldiabetes-management-practices-survey-idmps
- Satoh J, et al. PloS One. 2018;13(9):e0198160.
- Giugliano D, et al. Diabetes Care. 2014;37(2):372-380
- Kalra S, et al. Diabetes Ther. 2018 Dec;9(6):2185-2199.
- A Randomized, 24 Weeks, Active-controlled, Open-label, 2-arm Multicenter Study Comparing the Efficacy and Safety of iGlarlixi to IDegAsp in Chinese Type 2 Diabetes Mellitus Participants lnsufficiently Controlled With Oral Antidiabetic Drug(s). https://classic.clin icaltrials.gov/ct2/show/NCT05413369 Last accessed April 29,2024.
- Soliqua SmPC (KSA April 2020, Gulf August 2020).
