Practical implementation of ADA/EASD consensus algorithm in patients with type 2 diabetes in Pakistan

To ascertain the effectiveness of implementing the American Diabetes Association/European Association for the Study of Diabetes 2009 consensus algorithm in achieving glycaemic control in patients with type 2 diabetes.

The prospective, observational, open label, product registry was conducted at 38 sites across 7 cities in Pakistan between July 2011 and February 2014. Uncontrolled type 2 diabetes patients were either initiated on or switched to insulin glargine from other basal insulin. Glycated haemoglobin and fasting blood glucose were measured at baseline, 3 and 6 months.

Of the 307 patients, 166(54%) were males. At baseline, the overall mean age was 49.5 ± 8.7 years. Mean duration of diabetes was 7.1 ± 4.5 years. Both fasting blood glucose and glycated haemoglobin levels significantly reduced from baseline to 3 months to 6 months (p<0.01). At 6 months, 18(5.8%) patients reported 41 hypoglycaemic episodes of which 19(46.3%) were asymptomatic and 22(53.6%) were symptomatic. No severe hypoglycaemic episodes were reported.

Insulin initiation and titration as per American Diabetes Association/European Association for the Study of Diabetes guidelines helped in achieving glycaemic targets without increasing the risk of hypoglycaemia.