The effects of insulin glargine treatment and an educational programme on glycaemic control in type 2 diabetes patients in clinical practice

OBJECTIVE: This retrospective analysis was performed to establish the effect of initiating insulin glargine (LANTUS; sanofi-aventis, Paris, France), a once-daily basal insulin analogue, in combination with an educational programme on glycaemic control and body weight in sub-optimally controlled patients with Type 2 diabetes in clinical practice. RESEARCH DESIGN AND METHODS: We undertook a retrospective review of the medical records of 46 patients (mean age 61.5 +/- 8.6 years) with Type 2 diabetes. These patients had previously been treated with oral antidiabetic agents (OADs; n = 18) or insulin only (n = 28) and had then received insulin glargine in combination with OADs or prandial insulin, for 30 months. Records of metabolic control and body weight data were analysed at 9 and 30 months. Patients had taken part in a diabetes educational programme before initiation of insulin glargine and received continued physician consultations throughout. RESULTS: Following initiation of insulin glargine, patients showed a significant decrease in HbA1c from 8.14 +/- 1.7% to 7.18 +/- 0.9% at 30 months (p < 0.001). When the results were analysed by pre-treatment, patients pre-treated with OADs showed a reduction in HbA1c of 2.3% at 30 months (p < 0.001), while patients pre-treated with insulin only showed a decrease in HbA1c of 0.4% (p < 0.005). There was no significant change in body weight. No unexpected adverse events or episodes of severe hypoglycaemia (blood glucose < 40 mg/dL < 2.2 mmol/L]) occurred. CONCLUSIONS: Insulin glargine in combination with educational support and close clinical supervision significantly improved metabolic control without significant weight change in patients with Type 2 diabetes in clinical practice over 30 months. Additional studies are required to establish if similar results can be obtained in a larger cohort of patients.