Hajos T.R.S.,University Medical Center |
Hajos T.R.S.,EMGO Research Institute |
Pouwer F.,University of Tilburg |
de Grooth R.,Sanofi S.A. |
And 6 more authors.
Diabetic Medicine | Year: 2011
Aims To study prospectively the impact of initiating insulin glargine in suboptimally controlled insulin-naïve patients with Type2 diabetes on health-related quality of life in relation to glycaemic control. Methods Insulin-naïve Dutch patients with Type2 diabetes in suboptimal glycaemic control (HbA 1c >53mmol/mol; 7%) on maximum dose of oral glucose-lowering medications were included from 363 primary care practices (n=911). Patients started insulin glargine and were followed up for 6months. At baseline (start insulin therapy), 3 and 6months, HbA 1c was measured and patients completed self-report health-related quality of life measures, including emotional well-being (World Health Organization-5 well-being index), fear of hypoglycaemia (Hypoglycaemia Fear Survey) and diabetes symptom distress (Diabetes Symptom Checklist-revised). Data were analysed using generalized estimating equations analysis. Results HbA 1c (mmol/mol; %) decreased from 69±16; 8.5±1.7 to 60±11; 7.6±1.0 and 57±11; 7.3±1.0 at 3 and 6months, respectively (P<0.001). Pre-insulin BMI (kg/m 2) was 30±5.7, which remained stable at 3months (30±5.8) and increased to 31±5.9 at 6months (P=0.004); no significant changes in self-reported symptomatic and severe hypoglycaemia were observed, while nocturnal hypoglycaemia slightly decreased. The Hypoglycaemia Fear Survey score decreased from 14.6±16.2 to 12.1±15.2 and 10.8±14.4 at 3 and 6months, respectively (P<0.001). The Diabetes Symptom Checklist-revised score decreased from 15±14 to 10±12 and 10±13 (P<0.001), with most pronounced reductions in hyperglycaemic symptoms and fatigue. The World Health Organization-5 score increased from 57±25.3 to 65±21.6 at 3-month follow-up and 67±21.8 at 6-month follow-up (P<0.001). Conclusions Results of this observational study demonstrate combined glycaemic and health-related quality of life benefits of initiating insulin glargine in patients with Type2 diabetes in routine primary care. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.