Comparison of Antidiabetic Regimens in Patients with Type 2 Diabetes Uncontrolled by Combination Therapy of Sulfonylurea and Metformin: Results of the MOHAS Disease Registry in Korea.
10.4093/dmj.2017.41.3.170
- Author:
Sung Hee CHOI
1
;
Tae Jung OH
;
Hak Chul JANG
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. janghak@snu.ac.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Diabetes mellitus, type 2;
Insulin therapy;
Oral hypoglycemic agent
- MeSH:
Diabetes Mellitus, Type 2;
Hemoglobin A, Glycosylated;
Humans;
Hypoglycemic Agents;
Insulin;
Korea*;
Metformin*;
Observational Study;
Prospective Studies
- From:Diabetes & Metabolism Journal
2017;41(3):170-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to investigate the glucose-lowering efficacy of antidiabetic treatments in patients with type 2 diabetes mellitus (T2DM) uncontrolled by sulfonylurea plus metformin. METHODS: This open-label, multicenter, prospective, observational study was conducted in 144 centers in Korea, from June 2008 to July 2010, and included patients with T2DM who had received sulfonylurea and metformin for at least 3 months and had levels of glycosylated hemoglobin (HbA1c) >7.0% in the last month. Data of clinical and biochemical characteristics were collected at baseline and 6 months after treatment. The treatment option was decided at the physician's discretion. Subjects were classified into the following three groups: intensifying oral hypoglycemic agents (group A), adding basal insulin (group B), or starting intensified insulin therapy (group C). RESULTS: Of 2,995 patients enrolled, 2,901 patients were evaluated, and 504 (17.4%), 2,316 (79.8%), and 81 patients (2.8%) were classified into groups A, B, and C, respectively. Subjects in group C showed relatively higher baseline levels of HbA1c and longer duration of diabetes. The mean decrease in HbA1c level was higher in the insulin treated groups (−0.9%±1.3%, −1.6%±1.3%, and −2.4%±2.3% in groups A, B, and C, respectively, P=0.042). The proportion of patients who achieved target HbA1c <7.0% was comparable among the groups; however, intensified insulin therapy seemed to be the most effective in achieving the target HbA1c of 6.5%. CONCLUSION: These findings suggest that insulin-based therapy will be an important option in the improved management of Korean patients with T2DM whose glycemic control is not sufficient with sulfonylurea and metformin.
