Diabetes Metab J.  2015 Dec;39(6):481-488. 10.4093/dmj.2015.39.6.481.

Insulin Initiation in Insulin-Naive Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study

• Kim SS
• Kim IJ
• Kim YK
• Yoon KH
• Son HY
• Park SW
• Sung YA
• Baek HS

• KMID: 2174000
• DOI: http://doi.org/10.4093/dmj.2015.39.6.481

Abstract

BACKGROUND
The Modality of Insulin Treatment Evaluation (MOTIV) study was performed to provide real-world data concerning insulin initiation in Korean type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control with oral hypoglycemic agents (OHAs).
METHODS
This multicenter, non-interventional, prospective, observational study enrolled T2DM patients with inadequate glycemic control (glycosylated hemoglobin [HbA1c] > or =7.0%) who had been on OHAs for > or =3 months and were already decided to introduce basal insulin by their physician prior to the start of the study. All treatment decisions were at the physician's discretion to reflect real-world practice.
RESULTS
A total of 9,196 patients were enrolled, and 8,636 patients were included in the analysis (mean duration of diabetes, 8.9 years; mean HbA1c, 9.2%). Basal insulin plus one OHA was the most frequently (51.0%) used regimen. After 6 months of basal insulin treatment, HbA1c decreased to 7.4% and 44.5% of patients reached HbA1c <7%. Body weight increased from 65.2 kg to 65.5 kg, which was not significant. Meanwhile, there was significant increase in the mean daily insulin dose from 16.9 IU at baseline to 24.5 IU at month 6 (P<0.001). Overall, 17.6% of patients experienced at least one hypoglycemic event.
CONCLUSION
In a real-world setting, the initiation of basal insulin is an effective and well-tolerated treatment option in Korean patients with T2DM who are failing to meet targets with OHA therapy.

Keyword

Basal insulin; Diabetes mellitus, type 2; Korea; Pragmatic clinical trials as topic

MeSH Terms

Body Weight
Diabetes Mellitus, Type 2
Humans
Hypoglycemic Agents*
Insulin*
Korea
Observational Study
Pragmatic Clinical Trials as Topic
Prospective Studies
Hypoglycemic Agents
Insulin

Figure

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  Fig. 1 Patient disposition. HbA1c, glycosylated hemoglobin.

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  Fig. 2 (A) Glycosylated hemoglobin (HbA1c), (B) control rate (HbA1c <7%), (C) body weight, and (D) insulin dose at baseline, month 3 and 6. aAll P values are compared to baseline.

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  Fig. 3 (A) Glycosylated hemoglobin (HbA1c), (B) fasting blood glucose (FBG), (C) body weight, and (D) insulin dose at base, month 3 and 6 by groups. Group A: basal insulin only, group B: basal insulin+1 oral hypoglycemic agent (OHA), group C: basal insulin+≥2 OHAs, and group D: basal insulin+short acting insulin. All P values compared the difference between groups at week 24.

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