Results from the UK cohort of SOLVE: Providing insights into the timing of insulin initiation in people with poorly controlled type 2 diabetes in routine clinical practice

Aims: SOLVE was a large observational study of more than 17,000 insulin-naive patients with type 2 diabetes, investigating basal insulin analogue initiation in a primary care setting across a diverse geographical area. The current analysis aimed to compare and contrast the results of the UK cohort with the previously published global population results. Methods: This analysis compares the UK cohort of SOLVE (n = 761) with the global population (n = 17,374). Patients eligible for the study were those for whom a clinical decision had been made to initiate treatment with a basal insulin analogue once daily as an add-on to existing OAD therapy. Results: The UK cohort had a higher baseline HbA1c compared to the global population of SOLVE (9.8% vs. 8.9%, respectively) despite a shorter duration of disease, indicating that strict glycaemic targets set by international organisations are not being achieved in the UK. Following 24 weeks' treatment with insulin detemir, patients in the UK achieved a reduction in HbA1c of -1.3%, the same as the reduction achieved in the global population; however, a higher dose of insulin detemir was required in the UK than in the global population. Conclusions: Findings from the UK cohort of SOLVE show that it is possible to improve glycaemic control and reduce HbA1c in patients previously uncontrolled with oral antidiabetic drug therapy, in a primary setting, despite clinical inertia. (C)2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.