Insulin analogues: how observational studies provide key insights into management of patients with type 2 diabetes mellitus

Abstract

Objective:

The aim of this commentary was to evaluate the current evidence regarding the use of synthetic insulin analogues in the ‘real-world’ clinic setting for the treatment of type 2 diabetes mellitus (T2DM).

Methods:

Relevant publications were searched on PubMed MEDLINE, EMBASE, Cochrane Register of Controlled Trials Google Scholar, NLM Gateway, Science Direct, Web of Science and OVID for the period of January 2007 to June 2010. Articles were included if they (a) provided specific study results on the use of insulin analogues in T2DM and (b) gave sufficiently clear methodology details to establish treatment strategies, diagnosis and diagnostic criteria using an observational study (OS) design.

Results:

Twenty one articles specifically addressing both type 2 diabetes management and the use of synthetic insulin analogues were identified. Results from recently published OS in patients with T2DM have shown, in the patient populations tested, the effective initiation, optimization and switch to use of insulin analogues in routine clinical settings (day-to-day common practice), with a good safety profile.

Conclusions:

OS can provide clinicians with additional insights into the management of T2DM patients in their practices. However, the selection and initiation of insulin analogue regimens should be tailored to the individual patient and be one that the physician is comfortable using.

Key words::

• Diabetes treatment
• Glycaemic control
• Insulin analogues
• Nonrandomized
• Observational studies
• Prospective
• Type 2 diabetes

Transparency

Declaration of funding

Funding to support the preparation of the manuscript was provided by Novo Nordisk A/S.

Declaration of financial/other relationships

R.J.L. has received honoraria and is a member of an International Advisory Board for Novo Nordisk and has served as a consultant for GlaxoSmithKline and Eli Lilly.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The author wishes to thank Dr Nate Stepner, Six Degrees Medical Consulting for providing assistance with literature search, Carolyn Whiting, Six Degrees Medical Consulting for medical writing and editorial assistance, and Dr Christopher Burton, Point of Care for editorial assistance.

Notes

*IMPROVE is a registered trade name of Novo Nordisk A/S, Bagsvaerd, Denmark.

†PREDICTIVE is a registered trade name of Novo Nordisk A/S, Bagsvaerd, Denmark.

‡Novomix is a registered trade name of Novo Nordisk A/S, Bagsvaerd, Denmark.