Efficacy and Safety of Patient-Led Dosage Adjustments of Insulin Glargine: A Preliminary Report of Basal-Supported Oral Therapy for Japanese Type 2 Diabetes Patients ()
ABSTRACT
To evaluate the clinical
utility for simple patient administered dose adjustment methods of insulin
glargine during outpatient visits compared with a physician managed titration,
changes in HbA1c and total daily dose of insulin were evaluated in 23 patients
by dividing patients into physician-led (PL) group and self-titration (ST)
group who were newly administered glargine basal-supported oral therapy (BOT)
while continuing oral antidiabetic drugs at the discretion of their attending
physician during regular outpatient visits. In the PL group, one month after
initiation of glargine, HbA1c followed a declining trend, although this was not
significant (P = 0.07), and decreased significantly after two and three months
(P < 0.05, respectively). However, after 12 months, the significant
difference had disappeared. By contrast, in the ST group, HbA1c did not
significantly decrease one month after initiation of glargine, but did drop
markedly after two and three months, with this trend continuing up to 12 months
(P < 0.005). On examining the differences between both groups, we found that
the initial dose was significantly larger in the PL group (P < 0.05),
whereas the dose increased significantly more in the ST group after three
months. While the insulin dose after 12 months was large in the ST group, no
statistically significant difference was noted between the two groups (P = 0.14)
whereas HbA1c was significantly low in the ST group. In conclusion, we believe
that patient-led basal insulin dosage adjustment is an effective and useful therapeutic
option when they can master self-monitoring of blood glucose.
Share and Cite:
Nakanishi, S. , Kubota, M. and Kishimoto, R. (2014) Efficacy and Safety of Patient-Led Dosage Adjustments of Insulin Glargine: A Preliminary Report of Basal-Supported Oral Therapy for Japanese Type 2 Diabetes Patients.
Journal of Diabetes Mellitus,
4, 77-84. doi:
10.4236/jdm.2014.42014.
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