PMID- 31335198
OWN - NLM
STAT- MEDLINE
DCOM- 20200721
LR  - 20221207
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Linking)
VI  - 21
IP  - 11
DP  - 2019 Nov
TI  - Effectiveness and Safety of Physician-Led Versus Patient-Led Titration of Insulin 
      Glargine in Indian Patients with Type 2 Diabetes Mellitus: A Subanalysis of the 
      Asian Treat to Target Lantus Study (ATLAS).
PG  - 656-664
LID - 10.1089/dia.2019.0037 [doi]
AB  - Background: Titration of basal insulin led by either the physician or the patient 
      is not well understood in India. This analysis of Indian subset of Asian Treat to 
      Target Lantus Study (ATLAS) compared effectiveness of patient-led with 
      physician-led titration of once-daily insulin glargine 100 U/mL (Glargine-U-100) 
      in patients with type 2 diabetes mellitus (T2DM) uncontrolled on oral 
      antidiabetes drug (OAD). Methods: In this open-label parallel group study, 
      randomized patients (either physician-led or patient-led [self-titration] group) 
      followed the same dose titration algorithm (fasting blood glucose [FBG] target 
      110 mg/dL [6.1 mmol/L]). The primary endpoint was change in mean glycated 
      hemoglobin (HbA1c) at week 24 in the patient-led group versus the physician-led 
      group. Results: Patients (40-75 years) were randomized to either the 
      physician-led group (n = 39) or the patient-led group (n = 36). At week 24, 
      self-titration led to a greater decline in HbA1c than physician-led titration 
      (-1.3% vs. -1.1%). Mean decrease in FBG was more in the patient-led group than in 
      the physician-led group (-53.7 mg/dL vs. -35.5 mg/dL). Mean daily dose of 
      Glargine-U-100 at week 24 was higher in the patient-led group than in the 
      physician-led group (30.0 U vs. 23.8 U). At any time during the study, 30.6% and 
      7.7% of patients in the patient-led and physician-led groups, respectively, 
      showed target HbA1c level of <7.0% without severe hypoglycemia. Treatment 
      satisfaction and quality of life improved in both groups. Overall, treatment was 
      safe and well tolerated, and none of the events led to treatment discontinuation. 
      Conclusion: Patient-led adjustment of Glargine-U-100 in outpatient setting can be 
      a safe and effective method for glycemic control in Indian patients with T2DM 
      uncontrolled on OADs.
FAU - Misra, Anoop
AU  - Misra A
AD  - Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and 
      Endocrinology, New Delhi, India.
FAU - Patel, Mayur
AU  - Patel M
AD  - All India Institute of Diabetes and Research, Swasthya Diabetes Care, Jay Mangal 
      Society, Ahmedabad, India.
FAU - Agarwal, Pankaj
AU  - Agarwal P
AD  - Hormone Care and Research Centre SB-5, Ghaziabad, India.
FAU - Lodha, Sailesh
AU  - Lodha S
AD  - Dear Foundation, Jaipur, India.
FAU - Tandon, Nikhil
AU  - Tandon N
AD  - Department of Endocrinology, 3rd Floor Biotechnology Block, AIIMS, New Delhi, 
      India.
FAU - Magdum, Mohan
AU  - Magdum M
AD  - Jehangir Clinical Development Pvt. Ltd., Jehangir Hospital, Pune, India.
FAU - Yajnik, Chittaranjan
AU  - Yajnik C
AD  - Diabetes Unit, KEM hospital Research Centre, Pune, India.
FAU - Ghosh, Romik
AU  - Ghosh R
AD  - Medical Affairs Department, Sanofi, Mumbai, India.
FAU - Walekar, Ajit
AU  - Walekar A
AD  - Clinical Study Unit, Sanofi, Mumbai, India.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20190809
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
RN  - 2ZM8CX04RZ (Insulin Glargine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Blood Glucose/*drug effects
MH  - *Blood Glucose Self-Monitoring
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy/epidemiology
MH  - Female
MH  - Glycated Hemoglobin/*drug effects
MH  - Humans
MH  - Hypoglycemia/blood/drug therapy/epidemiology/*prevention & control
MH  - Hypoglycemic Agents/*administration & dosage
MH  - India/epidemiology
MH  - Insulin/administration & dosage/analogs & derivatives
MH  - Insulin Glargine/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Patient Satisfaction/statistics & numerical data
MH  - Retrospective Studies
MH  - Self Administration/statistics & numerical data
MH  - Treatment Outcome
OTO - NOTNLM
OT  - HbA1c
OT  - Patient-led insulin titration
OT  - Phase IV study
OT  - Physician-led insulin titration
OT  - Type 2 diabetes mellitus
EDAT- 2019/07/25 06:00
MHDA- 2020/07/22 06:00
CRDT- 2019/07/24 06:00
PHST- 2019/07/25 06:00 [pubmed]
PHST- 2020/07/22 06:00 [medline]
PHST- 2019/07/24 06:00 [entrez]
AID - 10.1089/dia.2019.0037 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2019 Nov;21(11):656-664. doi: 10.1089/dia.2019.0037. Epub 
      2019 Aug 9.