Subject    :    [2017 Feb;41(1)] Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT)
Writer KDA
Date 2017-03-23 10:33:01 Hit 6,301
Diabetes Metab J. 2017 Feb;41(1):31-37. English. Published online Oct 25, 2016.  https://doi.org/10.4093/dmj.2017.41.1.31 
Copyright © 2017 Korean Diabetes Association
   
Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT)
Mohammad Ebrahim Khamseh,1 Gholamreza Yousefzadeh,2 Zahra Banazadeh,3 and Sahar Ghareh4
1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
2Endocrinology and Metabolism Research Center, Institute of Basic and Clinic Physiology Science and Department of Internal Medicine, Kerman University of Medical Sciences, Kerman, Iran.
3Department of Internal Medicine, Lolagar Hospital, Iran University of Medical Sciences, Tehran, Iran.
4Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Islamic Azad University, Mashhad Medical Branch, Mashhad, Iran.
Corresponding author: Mohammad Ebrahim Khamseh. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Firouzeh St., South Vali-Asr Ave., Tehran, Iran. Email: khamseh.m@iums.ac.ir 
 
Received April 19, 2016; Accepted July 13, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract
Background

The aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c)

Methods

This study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24.

Results

Seven hundred and twenty-five people with T2DM (63% female) including both insulin naïve and prior insulin users were recruited in this study. The mean age of the participants was 54.2±11.2 years, and the mean HbA1c level was 8.88%±0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c ≤7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly.

Conclusion

Treatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile.

   
Keywords:
Diabetes mellitus, type 2; Hemoglobin A, glycosylated; Insulin glargine

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