PMID- 35617250
OWN - NLM
STAT- MEDLINE
DCOM- 20220530
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 17
IP  - 5
DP  - 2022
TI  - Glycemic control in newly insulin-initiated patients with type 2 diabetes 
      mellitus: A retrospective follow-up study at a university hospital in Ethiopia.
PG  - e0268639
LID - 10.1371/journal.pone.0268639 [doi]
LID - e0268639
AB  - BACKGROUND: Though many trials had examined the effectiveness of taking insulin 
      with or without oral agents, there are limited real-world data, particularly 
      among patients with type 2 diabetes mellitus (T2DM) in the resource limited 
      settings. This study aimed to examine level of glycemic control among patients 
      with T2DM after initiation of insulin and factors associated with poor glycemic 
      control. METHODS: An analysis of retrospective medical records of patients with 
      T2DM who initiated insulin due to uncontrolled hyperglycemia by oral agents was 
      conducted from 2015-2020 in the University of Gondar Comprehensive Specialized 
      Hospital. Difference in median fasting plasma glucose (FPG) before and after 
      insulin initiations was examined by a Wilcoxon signed-rank test. Kruskal Wallis 
      test was performed to explore difference in the median level of FPG among 
      treatment groups. A logistic regression model was also used to identify 
      associated factors of poor glycemic control after insulin initiation. Statistical 
      significance was declared at p < 0.05. RESULTS: Of 424 enrolled patients with 
      T2DM, 54.7% were males and the mean age was 59.3+/-9.3 years. A Wilcoxon 
      signed-rank test showed that there was significant deference in FPG before and 
      after insulin initiation (P < 0.001). A declining trend of blood glucose was 
      observed during the 1-year follow-up period of post-initiation. However, majority 
      of the participants did not achieve target glucose levels. Participants who had 
      higher FPG and systolic blood pressure (SBP) before insulin initiation were found 
      more likely to have poor glycemic control after insulin initiation. Similarly, 
      patients who received atorvastatin compared with simvastatin were found to have 
      poor glycemic control in the post-period of initiation (P = 0.04). Premixed 
      insulin was associated with a lower likelihood of poor glycemic control than 
      neutral protamine Hagedorn (NPH) insulin (P < 0.001). CONCLUSION: Following 
      insulin initiation, a significant change in glycemic level and declining trend of 
      FPG was observed during a 1-year follow-up period. However, the majority of 
      patients still had a poorly controlled glycemic level. Appropriate management 
      focusing on predictors of glycemic control would be of a great benefit to achieve 
      glycemic control.
FAU - Sendekie, Ashenafi Kibret
AU  - Sendekie AK
AUID- ORCID: 0000-0001-5982-853X
AD  - Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and 
      Health Sciences, University of Gondar, Gondar, Ethiopia.
FAU - Teshale, Achamyeleh Birhanu
AU  - Teshale AB
AD  - Department of Epidemiology and Biostatistics, Institute of Public health, College 
      of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
FAU - Tefera, Yonas Getaye
AU  - Tefera YG
AD  - Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and 
      Health Sciences, University of Gondar, Gondar, Ethiopia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220526
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Regular, Human)
RN  - 53027-39-7 (Insulin, Isophane)
SB  - IM
MH  - Aged
MH  - Blood Glucose/analysis
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Ethiopia
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/analysis
MH  - Glycemic Control
MH  - Hospitals, University
MH  - Humans
MH  - *Hyperglycemia
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - Insulin, Isophane
MH  - Insulin, Regular, Human
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
PMC - PMC9135271
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/05/27 06:00
MHDA- 2022/05/31 06:00
PMCR- 2022/05/26
CRDT- 2022/05/26 13:44
PHST- 2022/03/19 00:00 [received]
PHST- 2022/05/04 00:00 [accepted]
PHST- 2022/05/26 13:44 [entrez]
PHST- 2022/05/27 06:00 [pubmed]
PHST- 2022/05/31 06:00 [medline]
PHST- 2022/05/26 00:00 [pmc-release]
AID - PONE-D-22-08211 [pii]
AID - 10.1371/journal.pone.0268639 [doi]
PST - epublish
SO  - PLoS One. 2022 May 26;17(5):e0268639. doi: 10.1371/journal.pone.0268639. 
      eCollection 2022.