open access

Vol 69, No 4 (2018)
Original Paper
Published online: 2018-06-07
Submitted: 2018-01-04
Accepted: 2018-04-22
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Dose titration model and correlative factors analysis in Chinese patients with type-2 diabetes on basal insulin — results from an Observational Registry of Basal Insulin Treatment study

Jing Chen, Ying-Li Chen, Li-Nong Ji, Pu-Hong Zhang, Dong-Shan Zhu, Xian Li, Jia-Chao Ji, Fang Zhao, Heng Zhang
DOI: 10.5603/EP.a2018.0037
·
Pubmed: 29952407
·
Endokrynologia Polska 2018;69(4):395-402.

open access

Vol 69, No 4 (2018)
Original Paper
Published online: 2018-06-07
Submitted: 2018-01-04
Accepted: 2018-04-22

Abstract

Introduction: This study evaluates an insulin dose titration model and factors that impact insulin dose adjustment in Chinese adults with type-2 diabetes, who receive basal insulin in real-world settings.

Material and methods: A total of 19,894 patients from the ORBIT study were included. These patients were divided into four groups, according to the type of insulin dose adjustment: no insulin titration (group A), self-titration (group B), physician-led insulin titration (group C), and combined physician and patient-led insulin titration (group D). Data were collected and compared at baseline and after six months of treatment.

Results: A total of 12,865 patients completed the visits and were included in the analysis. Among these patients, 3187 (24.8%), 1971 (15.3%), 5165 (40.1%), and 2542 (19.8%) patients were included in groups A, B, C, and D, respectively. The multivariate logistic regression analysis revealed that the duration of diabetes, body mass index, microvascular complications, inpatient days, HbA1C level, and self-monitoring of blood glucose (SMBG) were positively correlated with insulin titration in group B, C, and D, compared with group A. The number of inpatient days and outpatient visits were positively correlated with dose adjustment for physician-led titration, while this was negatively correlated for self-titration. Self-titration encouraged by physicians and home blood glucose monitoring were positively correlated with self-titration and the combined physician and patient-led titration.

Conclusions: High HbA1C level, SMBG, long disease duration, microvascular complications, and the encouragement of physicians while initiating insulin use prompt patients to perform dose adjustments in real-world settings.

Abstract

Introduction: This study evaluates an insulin dose titration model and factors that impact insulin dose adjustment in Chinese adults with type-2 diabetes, who receive basal insulin in real-world settings.

Material and methods: A total of 19,894 patients from the ORBIT study were included. These patients were divided into four groups, according to the type of insulin dose adjustment: no insulin titration (group A), self-titration (group B), physician-led insulin titration (group C), and combined physician and patient-led insulin titration (group D). Data were collected and compared at baseline and after six months of treatment.

Results: A total of 12,865 patients completed the visits and were included in the analysis. Among these patients, 3187 (24.8%), 1971 (15.3%), 5165 (40.1%), and 2542 (19.8%) patients were included in groups A, B, C, and D, respectively. The multivariate logistic regression analysis revealed that the duration of diabetes, body mass index, microvascular complications, inpatient days, HbA1C level, and self-monitoring of blood glucose (SMBG) were positively correlated with insulin titration in group B, C, and D, compared with group A. The number of inpatient days and outpatient visits were positively correlated with dose adjustment for physician-led titration, while this was negatively correlated for self-titration. Self-titration encouraged by physicians and home blood glucose monitoring were positively correlated with self-titration and the combined physician and patient-led titration.

Conclusions: High HbA1C level, SMBG, long disease duration, microvascular complications, and the encouragement of physicians while initiating insulin use prompt patients to perform dose adjustments in real-world settings.

Get Citation

Keywords

type 2 diabetes, basal insulin therapy, diabetes education, real-world settings, ORBIT study

About this article
Title

Dose titration model and correlative factors analysis in Chinese patients with type-2 diabetes on basal insulin — results from an Observational Registry of Basal Insulin Treatment study

Journal

Endokrynologia Polska

Issue

Vol 69, No 4 (2018)

Pages

395-402

Published online

2018-06-07

DOI

10.5603/EP.a2018.0037

Pubmed

29952407

Bibliographic record

Endokrynologia Polska 2018;69(4):395-402.

Keywords

type 2 diabetes
basal insulin therapy
diabetes education
real-world settings
ORBIT study

Authors

Jing Chen
Ying-Li Chen
Li-Nong Ji
Pu-Hong Zhang
Dong-Shan Zhu
Xian Li
Jia-Chao Ji
Fang Zhao
Heng Zhang

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