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Lookup NU author(s): Emeritus Professor Philip Home
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2017 The Authors Aims A number of insulin regimens are used in type 2 diabetes. This analysis aims to better understand the evolution of insulin therapy in different regions of Europe. Methods Data from people starting any insulin were collected in eastern Europe (EEur: Croatia, Russia, Ukraine), northern Europe (NEur: Finland, Germany, UK) and southern Europe (SEur: France, Italy, Portugal, Spain). Retrospective data on starting insulin and prospective follow-up data were extracted from clinical records. Results At 4 years, 1699 (76.0%) of 2236 eligible people had data. EEur participants were mostly female, younger and had shorter diabetes duration on starting insulin, yet had highest baseline HbA1c and more micro-/macrovascular disease. A majority (60%–64%) in all regions started on basal insulin alone, declining to 30%–38% at 4 years, with most switching to basal + mealtime insulin regimen (24%–40%). Higher baseline (28%) and 4-year use (34%) of premix insulin was observed in NEur. Change in HbA1c (SD) ranged from −1.2 (2.1)% (−13 [23] mmol/mol) in NEur to −2.4 (2.0)% (−26 [22] mmol/mol) in EEur. Weight change ranged from +1.9 (8.3) kg in NEur to +3.2 (7.0) kg in SEur. Overall documented hypoglycemia ranged from 0.3 (1.3) to 1.3 (4.4) events/person/6-months (NEur vs. EEur, respectively) and was stable with time. Severe hypoglycemia rates remained low. Conclusion When starting insulin, HbA1c and prevalence of complications were higher in EEur. Regional differences exist in choice of insulin regimens in Europe. However, people starting insulin improved and sustained their glycemic control regardless of regional differences or insulin regimens used.
Author(s): Blonde L, Marre M, Vincent M, Brette S, Pilorget V, Danchin N, Vespasiani G, Home P
Publication type: Article
Publication status: Published
Journal: Diabetes Research and Clinical Practice
Year: 2017
Volume: 133
Pages: 150-158
Print publication date: 01/11/2017
Online publication date: 31/08/2017
Acceptance date: 21/08/2017
Date deposited: 24/10/2017
ISSN (print): 0168-8227
ISSN (electronic): 1872-8227
Publisher: Elsevier Ireland Ltd
URL: https://doi.org/10.1016/j.diabres.2017.08.016
DOI: 10.1016/j.diabres.2017.08.016
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