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Published on: June 11, 2012
Longitudinal change in HbA1c after insulin initiation in primary care patients with type 2 diabetes: a database
Wolfgang Rathmann1, Klaus Strassburger, Teresa Tamayo
1Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf’m Hennekamp 65, Düsseldorf, Germany. rathmann@ddz.uni-duesseldorf.de
Aims:
To evaluate the 3-year change in HbA1c values after start of insulin therapy among patients with type 2 diabetes in primary care practices in UK and Germany.
Methods:
Longitudinal data from general practices in Germany and UK (Disease Analyser, IMS HEALTH) from 2005 to 2009 were analysed, including 779 patients (mean age±SD: 63±11yrs, HbA1c: 8.1±1.3%) in Germany and 646 patients (55±12yrs; 9.3±1.5%) in UK with first time insulin prescriptions in 2005 (index date). The mean individual relative changes in HbA1c over 3 years after index date were adjusted for age, sex, diabetes duration, oral antidiabetics, insulin type, comorbidity and visits using general linear models.
Results:
The average adjusted HbA1c improvements in the first 12 months in primary care patients were 0.5% (95%CI: 0.4-0.6%) in Germany and 1.0% (0.7-1.3%) in UK. Between 12 and 36 months these improvements in glycemic control were maintained in both patient groups.
Discussion:
Initiation of insulin therapy in primary care patients in Germany and UK was associated with a similar moderate improvement in glycemic control over the first 12 months. After this period, insulin therapy only maintained HbA1c values without additional improvement in glycemic control.
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