02643nas a2200277   4500000000100000008004100001100001400042700001300056700001200069700001600081700001700097700001500114700001400129700001600143700001600159700001800175700001700193700001400210700001800224700001600242700001200258700001600270245018500286520188000471022001402351       2017                            d1 aJi Linong1 aZhang P.1 aLi Xian1 aWu Yangfeng1 aZhu Dongshan1 aJi Jiachao1 aLu Juming1 aGuo Xiaohui1 aJia Weiping1 aWeng Jianping1 aYang Wenying1 aZou Dajin1 aZhou Zhiguang1 aPan Changyu1 aGao Yan1 aGarg Satish00aObservational Registry of Basal Insulin Treatment (ORBIT) in patients with type 2 diabetes uncontrolled with oral antihyperglycaemic drugs: Real-life use of basal insulin in China.3 a<p>
<b>AIMS: </b>To examine treatment patterns following basal insulin (BI) introduction in type 2 diabetes mellitus (T2DM) patients under real-world conditions across China.
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<b>MATERIALS AND METHODS: </b>Overall, 18 995 patients inadequately controlled (HbA1c ≥ 53 mmol/mol [7%]) with oral antihyperglycaemic drugs (OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3). Type of BI was initiated at physicians' discretion.
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<b>RESULTS: </b>Retention with BI therapy at 6 months was 75.6%. Use of long-acting BI predominated, with insulin glargine accounting for 71%, detemir 13% and Neutral Protamine Hagedorn (NPH) insulin 16%. Over 70% of long-acting users maintained the same initial BI at visit 3, while 40% of NPH users switched treatment and 24.4% of participants initiated BI with prandial insulin. The initial mean (± SD) dose of BI and total insulin was 0.18 ± 0.07 and 0.25 ± 0.19 IU/kg, respectively, with a mean increase of daily dose by 0.03 and 0.02 IU/kg after 6 months, respectively. Only 56.6% of insulin users reported dose titration at visit 3. Mean HbA1c was 81 mmol/mol (9.6%) at baseline and 57 mmol/mol (7.4%) at 6 months. The frequency of hypoglycaemia was 1.61 and 2.07 episodes/patient-year at baseline and 6 months, respectively.
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<b>CONCLUSIONS: </b>In real-world clinical settings, add-on BI therapy in T2DM patients is associated with significant improvement in glycaemic control without overtly compromising safety related to hypoglycaemia and weight gain. Evolution of insulin treatment regimens varied among patients, but dose titration was suboptimal. More active BI dose titration might further improve glycaemic outcome in patients receiving BI therapy.
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