Abstract
Aims
We aimed to identify diabetes-related predictors associated with achieving glycosylated hemoglobin (HbA1c) <7.0 % by using data from the Add-on Lantus® to Oral Hypoglycemic Agents (ALOHA) study, a 24-week observational study of Japanese type 2 diabetes patients.
Materials and methods
Among insulin-naïve patients (n = 3515), those who achieved HbA1c <7.0 % at the final visit were categorized as achievers and others as nonachievers. Relationships between baseline factors and achievement of HbA1c <7.0 % were examined by univariate and multivariate analysis.
Results
Of 3,515 patients, 545 (15.5 %) achieved HbA1c <7.0 % at 24 weeks (achievers), whereas 2,970 (84.5 %) did not achieve the target level (nonachievers). Patients with diabetes duration <1 year were more likely to achieve HbA1c <7.0 % than those with diabetes duration ≥5 years (27 % for <1; 17 % for ≥1, <5; and 15 % for ≥5: P < 0.05 for the trend). The HbA1c <7.0 % responder rate was higher in those with baseline HbA1c <8.5 % than in the other baseline HbA1c categories (28 %; P < 0.001 vs. all other higher categories). Patients with retinopathy were less likely to achieve HbA1c <7.0 % (P < 0.001). These three factors also showed significant associations in the multivariate logistic regression model.
Conclusions
This study revealed shorter diabetes duration (<1 year), lower HbA1c (<8.5 %), and no retinopathy at baseline to be significantly associated with a higher rate of achieving the target HbA1c in insulin-naïve patients started on therapy with insulin glargine plus oral antidiabetic drugs. These results suggest that earlier initiation of insulin glargine will raise the likelihood of type 2 diabetes patients achieving optimal glycemic control (HbA1c <7.0 %).
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Acknowledgments
The authors thank all physicians at the 987 hospitals and clinics participating in the ALOHA study. This study was sponsored by sanofi-aventis K.K.
Conflict of interest
TK received an honorarium for a lecture from sanofi-aventis K.K.; TK and MO received advisory board fees as publication committee members; TO works for sanofi-aventis K.K.
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Kadowaki, T., Ohtani, T. & Odawara, M. Baseline predictive factors for glycemic control in Japanese type 2 diabetes patients treated with insulin glargine plus oral antidiabetic drugs: ALOHA study subanalysis. Diabetol Int 4, 16–22 (2013). https://doi.org/10.1007/s13340-012-0087-6
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DOI: https://doi.org/10.1007/s13340-012-0087-6