Insulin Glargine and Oral Anti-Diabetic Agents: A sound Start to Insulin Therapy

Within the framework of out-patient care in Germany, various ways to initiate insulin therapy in type 2 diabetics were compared. Data were taken from a representative longitudinal patient database on HbA(1c) frequency of use, and duration of the pre-treatment periods in the year 2007 as compared to 2000. Regression analysis revealed a significantly greater reduction in HbA(1c) in basal-supported oral therapy with insulin glargine compared to other combinations of oral anti-diabetic drugs and basal insulins, and to conventional therapy with pre-mixed insulins. When compared to prandial therapies using short-acting insulins, however, no major difference in HbA(1c) reduction was observed. Whereas the use of pre-mixed insulin was the most commonly prescribed treatment option in the year 2000 (75 %), the addition of a basal insulin to oral anti-diabetic agents was the most frequently prescribed form of therapy in 2007 (54 %), within which basal-supported oral therapy with insulin glargine was the most common (32 %). The length of stay on pre-treatment with oral anti-diabetic drugs before the switch to insulin therapy was reduced much more so with insulin glargine than with the other insulin regimens. In German routine health care, insulin glargine in combination with oral anti-diabetic agents has proved to be the most effective and commonly used treatment regime of initiating insulin therapy in type 2 diabetes.