New data presented at the ADA's Annual Scientific Sessions demonstrated the value of beginning insulin promptly when glycemic targets are not achieved with diet, exercise and oral medications alone
SAN FRANCISCO, June 7 /PRNewswire-FirstCall/ -- Results from a new studypresented at the American Diabetes Association's (ADA) 68th Annual ScientificSessions reinforce the importance of promptly initiating insulin treatmentwhen patients with type 2 diabetes are unable to achieve recommended glycemictargets with diet, exercise and oral diabetes medications alone. In the TULIP(Testing the Usefulness of Lantus(R) when Initiated Promptly in patients withtype 2 diabetes) clinical study, 66 percent of patients who began treatmentwith the long-acting, basal insulin Lantus(R) (insulin glargine [rDNA origin]injection) achieved A1C <7%, the ADA's recommended target for glycemiccontrol, while only 38 percent of patients from the lifestyle management armwere able to achieve the recommended target levels.
In an effort to help guide treatment decisions, the ADA and EuropeanAssociation for the Study of Diabetes (EASD) developed a Consensus Algorithmfor Type 2 Diabetes that calls for healthcare providers and diabetes patientsto initiate insulin therapy when A1C <7% is not achieved with oral medicationsand lifestyle management alone. However, physicians typically wait for A1C toapproach 9% before adding insulin. In general, every percentage point drop inA1C blood test results (e.g., from 8.0% to 7.0%) reduces the risk ofmicrovascular complications (eye, kidney, and nerve diseases) by 40%.
The most common side effect of any insulin, including Lantus(R), ishypoglycemia, which may be serious. In the Lantus(R) arm of the TULIP trial,there were 4.2 +/- 6.6 (p<0.0001) cases of symptomatic, 0.7 +/- 2.1 (p=0.0011)cases of nocturnal and 0.04 +/- 0.35 (p=0.147) cases of severe hypoglycemiaevents reported per patient year. However, no patients dropped out of thetrial due to hypoglycaemia.
'When glycemic targets are not achieved with diet, exercise and oralmedications given at maximum tolerated dose, patients with type 2 diabeteshave reached a critical moment in the lifecycle of their condition,' saidAndre Grimaldi, MD, Professor Diabetes Department Head, Pitie-SalpetriereHospital, Paris, France.
