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

Affiliations
  • 1Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. injkim@pusan.ac.kr
  • 2Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan. Korea.
  • 3Kim Yong Ki Internal Medicine Clinic, Busan, Korea.
  • 4Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 6Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.

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

  • Fig. 1 Patient disposition. HbA1c, glycosylated hemoglobin.

  • 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.

  • 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.


Cited by  1 articles

Therapeutic Effect of Quadruple Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus Who Have Insulin Limitations
Won Sang Yoo, Do Hee Kim, Hee Jin Kim, Hyun Kyung Chung
J Korean Diabetes. 2019;20(2):117-126.    doi: 10.4093/jkd.2019.20.2.117.


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