Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes

Background. Insulin is increasingly used for type 2 diabetes when oral therapy is inadequate. We have examined the results in unselected patients in a UK hospital diabetes clinic. Methods. Clinical database records from 1994 to 2002 were analysed for anthropomorphic data, blood pressure, HbA1C and p...

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Autores principales: Gardner, S, Dunachie, S, Levy, J
Formato: Journal article
Lenguaje:English
Publicado: 2004
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author Gardner, S
Dunachie, S
Levy, J
author_facet Gardner, S
Dunachie, S
Levy, J
author_sort Gardner, S
collection OXFORD
description Background. Insulin is increasingly used for type 2 diabetes when oral therapy is inadequate. We have examined the results in unselected patients in a UK hospital diabetes clinic. Methods. Clinical database records from 1994 to 2002 were analysed for anthropomorphic data, blood pressure, HbA1C and plasma cholesterol in type 2 diabetic patients starting insulin therapy. Results. In 335 patients, HbA1C at four years correlated positively with HbA1C before starting insulin (r=0.31, p< 0.01) and negatively correlated with age at the time of starting insulin (r=-0.19, p<0.01). In two cohorts changed to insulin therapy before and after publication of the results of the UKPDS (1998), HbA1C improved in the first year, with little subsequent change over four years, while weight continued to rise. The later cohort had a significantly greater reduction in HbA1C (p=0.001). Even in this group, only 21.6% of patients achieved HbA1C < 7.5%. Conclusions. In a UK diabetes clinic, insulin therapy for type 2 diabetes improved glycaemic control in the first year, but not thereafter, while weight gain continued in subsequent years. Tighter targets may have promoted improved results.
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spelling oxford-uuid:f9b15e89-e4e2-4026-b3e7-a9cc32230fde2022-03-27T12:59:47ZReal gains but practical limitations to glycaemic control with insulin in type 2 diabetesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f9b15e89-e4e2-4026-b3e7-a9cc32230fdeEnglishSymplectic Elements at Oxford2004Gardner, SDunachie, SLevy, JBackground. Insulin is increasingly used for type 2 diabetes when oral therapy is inadequate. We have examined the results in unselected patients in a UK hospital diabetes clinic. Methods. Clinical database records from 1994 to 2002 were analysed for anthropomorphic data, blood pressure, HbA1C and plasma cholesterol in type 2 diabetic patients starting insulin therapy. Results. In 335 patients, HbA1C at four years correlated positively with HbA1C before starting insulin (r=0.31, p< 0.01) and negatively correlated with age at the time of starting insulin (r=-0.19, p<0.01). In two cohorts changed to insulin therapy before and after publication of the results of the UKPDS (1998), HbA1C improved in the first year, with little subsequent change over four years, while weight continued to rise. The later cohort had a significantly greater reduction in HbA1C (p=0.001). Even in this group, only 21.6% of patients achieved HbA1C < 7.5%. Conclusions. In a UK diabetes clinic, insulin therapy for type 2 diabetes improved glycaemic control in the first year, but not thereafter, while weight gain continued in subsequent years. Tighter targets may have promoted improved results.
spellingShingle Gardner, S
Dunachie, S
Levy, J
Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title_full Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title_fullStr Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title_full_unstemmed Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title_short Real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
title_sort real gains but practical limitations to glycaemic control with insulin in type 2 diabetes
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AT dunachies realgainsbutpracticallimitationstoglycaemiccontrolwithinsulinintype2diabetes
AT levyj realgainsbutpracticallimitationstoglycaemiccontrolwithinsulinintype2diabetes