Characteristics of patients with type 2 diabetes mellitus initiating insulin therapy: baseline data from the INSTIGATE study*

ABSTRACT

Objective: To describe the characteristics at baseline of patients with type 2 diabetes mellitus who are initiating insulin.

Methods: Prospective, observational multi-centre, open-label study in five European countries of patients with type 2 diabetes who were initiating insulin as part of their usual care.

Results: A total of 1172 patients were enrolled, with mean age 63.3 years and body mass index 29.9 kg/m². The majority (90%) of patients were taking one or more oral anti-diabetic agents; the percentage not taking anti-diabetic medication in the previous four weeks was highest in Germany (23.4%) and Spain (15.1%). The prevalence of microvascular diseases (range: 16.1%–36.1%) varied considerably between countries but for macrovascular (30.4%–38.6%) and other diabetes-related diagnoses (72.6%–76.6%) such as hypertension and dyslipidaemia the differences were less pronounced. In Germany, reported use of lipid-lowering (26.7%) and anti-platelet (27.1%) therapies was much less than in other countries (ranges: 53.2%–78.1% and 48.3%–61.1%, respectively). The majority of evaluable patients in each country had demonstrated poor control over a long period of time. Prior to initiating insulin, the most recent mean (±SD) HbA1_c was 9.58 ± 1.81%, fasting plasma glucose was 12.18 ± 4.32 mmol/L and 78.5% had metabolic syndrome. IDF targets for HDL- and LDL-cholesterol, and blood pressure were met in 76.8%, 33.1% and 18.9% of patients, respectively.

Conclusions: Insulin treatment was only initiated after HbA1_c values were considerably higher than recommended in treatment guidelines for a sustained period of time.

Key words: :

• Concomitant diseases
• Glycaemic control
• Insulin therapy
• Oral anti-diabetic agents
• Type 2 diabetes

* Baseline results were presented at the European Association for the Study of Diabetes, Amsterdam, Netherlands, September 2007

* Baseline results were presented at the European Association for the Study of Diabetes, Amsterdam, Netherlands, September 2007

Acknowledgements

Declarations of interest: The INSTIGATE study was funded by Eli Lilly and Company.

The authors wish to thank Peter Bates, PhD of Influence Medical Communication, UK, for help in preparation of the manuscript; funding for this writing assistance was provided by Eli Lilly and Company. The authors are also very grateful to the members of the INSTIGATE International Advisory Board and Aline Charles.

S.J., M.B., C.C., A.G. and A.L. are members of the INSTIGATE advisory board. L.T., C.N., A.S. and A.T. are all employees of Eli Lilly and Company.

Notes

* Baseline results were presented at the European Association for the Study of Diabetes, Amsterdam, Netherlands, September 2007