HealthDay News — Less than half of newly diagnosed patients with type 2 diabetes achieve glycated hemoglobin (HbA1c) less than 7%, the American Diabetes Association target for glycemic control, and those that do achieve it more likely started with lower HbA1c levels, study data indicate.
“Insulin initiation at lower levels of HbA1c improves goal attainment and independently increases glycemic response,” Gregory A. Nichols, PhD, from the Kaiser Permanente Center for Health Research in Portland, Ore., and colleagues reported in Diabetes Care.
They studied 1,139 patients with type 2 diabetes who began insulin therapy between January 2009 and June 2010 and found that 464 patients (40.7%) achieved HbA1c levels less than 7% at mean five month follow-up. Mean HbA1c levels were lower at insulin initiation among those who achieved glycemic control compared with those who did not (8.2% vs. 9.2%; P<0.001).
A multivariable analysis revealed that preinsulin HbA1c levels were responsible for nearly all variance in gylcemic change after controlling for insulin regimen, dose and oral agent use. Each percentage point increase in preinsulin HbA1c reduced the probability of achieving glycemic control by 26% (OR=0.74; 95% CI: 0.68–0.80), the researchers determined.
Several researchers disclosed financial ties to pharmaceutical companies, including Merck Research Laboratories, which funded the study.