PMID- 28105735 OWN - NLM STAT- MEDLINE DCOM- 20180403 LR - 20221207 IS - 1463-1326 (Electronic) IS - 1462-8902 (Linking) VI - 19 IP - 6 DP - 2017 Jun TI - Observational Registry of Basal Insulin Treatment (ORBIT) in patients with type 2 diabetes uncontrolled with oral antihyperglycaemic drugs: Real-life use of basal insulin in China. PG - 822-830 LID - 10.1111/dom.12886 [doi] AB - AIMS: To examine treatment patterns following basal insulin (BI) introduction in type 2 diabetes mellitus (T2DM) patients under real-world conditions across China. MATERIALS AND METHODS: Overall, 18 995 patients inadequately controlled (HbA1c >/= 53 mmol/mol [7%]) with oral antihyperglycaemic drugs (OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3). Type of BI was initiated at physicians' discretion. RESULTS: Retention with BI therapy at 6 months was 75.6%. Use of long-acting BI predominated, with insulin glargine accounting for 71%, detemir 13% and Neutral Protamine Hagedorn (NPH) insulin 16%. Over 70% of long-acting users maintained the same initial BI at visit 3, while 40% of NPH users switched treatment and 24.4% of participants initiated BI with prandial insulin. The initial mean (+/- SD) dose of BI and total insulin was 0.18 +/- 0.07 and 0.25 +/- 0.19 IU/kg, respectively, with a mean increase of daily dose by 0.03 and 0.02 IU/kg after 6 months, respectively. Only 56.6% of insulin users reported dose titration at visit 3. Mean HbA1c was 81 mmol/mol (9.6%) at baseline and 57 mmol/mol (7.4%) at 6 months. The frequency of hypoglycaemia was 1.61 and 2.07 episodes/patient-year at baseline and 6 months, respectively. CONCLUSIONS: In real-world clinical settings, add-on BI therapy in T2DM patients is associated with significant improvement in glycaemic control without overtly compromising safety related to hypoglycaemia and weight gain. Evolution of insulin treatment regimens varied among patients, but dose titration was suboptimal. More active BI dose titration might further improve glycaemic outcome in patients receiving BI therapy. VIDEO ABSTRACT: A free Video Abstract to accompany this article is available at https://vimeo.com/212655959. CI - (c) 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. FAU - Ji, Linong AU - Ji L AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Zhang, Puhong AU - Zhang P AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Zhu, Dongshan AU - Zhu D AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Li, Xian AU - Li X AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Ji, Jiachao AU - Ji J AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Lu, Juming AU - Lu J AD - Department of Endocrinology, Chinese PLA General Hospital, Beijing, China. FAU - Guo, Xiaohui AU - Guo X AD - Department of Endocrinology, Peking University First Hospital, Beijing, China. FAU - Jia, Weiping AU - Jia W AD - Department of Endocrinology and Metabolism, Shanghai Sixth Hospital, Shanghai, China. FAU - Weng, Jianping AU - Weng J AD - Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. FAU - Wu, Yangfeng AU - Wu Y AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Yang, Wenying AU - Yang W AD - Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China. FAU - Zou, Dajin AU - Zou D AD - Department of Endocrinology, The Second Military Medical University, Shanghai, China. FAU - Zhou, Zhiguang AU - Zhou Z AD - Department of Endocrinology and Metabolism, Xiangya Second Hospital, Changsha, China. FAU - Pan, Changyu AU - Pan C AD - Department of Endocrinology, Chinese PLA General Hospital, Beijing, China. FAU - Gao, Yan AU - Gao Y AD - Department of Endocrinology, Peking University First Hospital, Beijing, China. FAU - Garg, Satish K AU - Garg SK AD - Barbara Davis Center for Diabetes, University of Colorado Denver, Denver, Colorado. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20170317 PL - England TA - Diabetes Obes Metab JT - Diabetes, obesity & metabolism JID - 100883645 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (Insulin, Long-Acting) RN - 0 (hemoglobin A1c protein, human) SB - IM MH - Aged MH - Blood Glucose/drug effects MH - China MH - Diabetes Mellitus, Type 2/blood/*drug therapy MH - Drug Therapy, Combination MH - Female MH - Glycated Hemoglobin/drug effects MH - Humans MH - Hypoglycemia/chemically induced MH - Hypoglycemic Agents/*administration & dosage MH - Insulin, Long-Acting/*administration & dosage MH - Male MH - Middle Aged MH - Registries MH - Treatment Outcome OTO - NOTNLM OT - basal insulin OT - observational study OT - type 2 diabetes EDAT- 2017/01/21 06:00 MHDA- 2018/04/04 06:00 CRDT- 2017/01/21 06:00 PHST- 2016/09/25 00:00 [received] PHST- 2017/01/10 00:00 [revised] PHST- 2017/01/17 00:00 [accepted] PHST- 2017/01/21 06:00 [pubmed] PHST- 2018/04/04 06:00 [medline] PHST- 2017/01/21 06:00 [entrez] AID - 10.1111/dom.12886 [doi] PST - ppublish SO - Diabetes Obes Metab. 2017 Jun;19(6):822-830. doi: 10.1111/dom.12886. Epub 2017 Mar 17.