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

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Abstract

Aims

Type 2 diabetes mellitus (T2DM) 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 insulins. The aim was to summarize published data in Adriatic countries on effectiveness of insulin glargine based therapy in type 2 diabetic patients suboptimally controlled on premix insulin.

Methods

A meta-analysis was carried out in major medical databases up to April 2014, focusing on 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 two hours 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-hours 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.

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Acknowledgments

We would like to thank Radenka Munjas Samarin for assistance with graphic design and editorial support, funded by Sanofi in the preparation of this manuscript. This study was sponsored by Sanofi.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, University Hospital Centre Sestre Milosrdnice, Vinogradska 29, 10000, Zagreb, Croatia

    Maja Cigrovski Berkovic

  2. Diabetes and Metabolic Disorders, University Clinic of Endocrinology, Vodnjanska 17, 1000, Skopje, Macedonia

    Goran Petrovski

  3. Sanofi, Zagreb, Croatia

    Natasa Grulovic

Authors
  1. Maja Cigrovski Berkovic
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  2. Goran Petrovski
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  3. Natasa Grulovic
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Corresponding author

Correspondence to Maja Cigrovski Berkovic.

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Conflict of interest

Maja Cigrovski Berković declares associations (lecturer, member of advisory board, clinical trial investigator) with the following companies: Astra-Zeneca, Boehringer-Ingelheim, Eli Lilly, Merck Sharpe & Dohme, Novartis, NovoNordisk, and Sanofi-Aventis. Goran Petrovski declares associations (lecturer, clinical trial investigator) with the following companies: Eli Lilly, NovoNordisk, Sanofi-Aventis, Medtronic and Alkaloid. Natasa Grulovic is an employee of Sanofi-Aventis.

Ethical standard

In the Manuscript we presented and analyzed data from different studies as a meta-analysis. All presented data comes from studies that were approved by local Ethical Committees.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the studies analyzed in the present meta-analysis.

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Managed by Antonio Secchi.

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Supplementary material 1 (DOC 43 kb)

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Cigrovski Berkovic, M., Petrovski, G. & Grulovic, N. Effectiveness of insulin glargine in type 2 diabetes mellitus patients failing glycaemic control with premixed insulin: Adriatic countries data meta-analysis. Acta Diabetol 53, 709–715 (2016). https://doi.org/10.1007/s00592-016-0861-1

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  • DOI: https://doi.org/10.1007/s00592-016-0861-1

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