GIANTT study identifies difference in HbA1c response after insulin start: toward a more personalized approach?

GIANTT study identifies difference in HbA1c response after insulin start: toward a more personalized approach? Monday April 30th, 2018

A new GIANTT study, recently published in the renowned diabetes journal “Diabetes, Obesity and Metabolism” shows that not every patient with diabetes type 2 has the same response in HbA1c after the start of insulin therapy. Investigator dr. Grigory Sidorenkov and colleagues included almost 1,500 patients (mean age: 65.6 years) who started with insulin between 2007 and 2013 and followed them for 2 to 4 years. Using longitudinal analyses, they identified three subgroups: Group 1 (8%) was a relatively younger subgroup who showed a small initial HbA1c decrease, but subsequently the HbA1c increased to more than 70 mmol/mol during follow-up despite more co-prescribing of oral glucose regulating medication. The authors speculate that non-adherence, known to be more prevalent in younger patients, could be an explanation. Group 2 was the largest sub-group (84%) and showed a stable HbA1c decrease to around 55 mmol/mol over the complete follow-up. Group 3 (8%) had on average a high initial HbA1c of more than 85 mmol/mol at start and showed a rapid decline followed by a slight increase to around 60 mmol/mol. This last group was recently diagnosed with diabetes type 2 and their blood pressure and LDL-cholesterol were relatively sub-optimally controlled at the time of insulin start. The results emphasize the need for a more personalized approach in therapy management and monitoring when starting insulin in patients with type 2 diabetes. Click here to read the full study.

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