CLINICAL OUTCOMES AFTER SWITCHING FROM PREMIXED INSULIN TO BASAL INSULIN IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN EVERYDAY CARE IN THE GULF REGION: THE I-TALENT STUDY

Type 2 diabetes mellitus (T2DM) prevalence in the Middle East is one of the highest in the world and glycemic control is frequently poor. Switching from other insulin regimens to a basal insulin has been shown to improve glycemic control in Europe and North America, but the benefits of such a strategy in Middle Eastern populations have not been demonstrated sufficiently. Our study aimed to describe the evolution of glycemic control in patients with T2DM who switched from premixed insulin to insulin glargine 100 U/mL (Gla-100). A multicentre, prospective, observational study (i-Talent) conducted between 2012 and 2014. Data were collected at three routine visits at Months 0, 3 and 6 from thirty public and private hospital centres involved in the management of T2DM from the United Arab Emirates, Kuwait and Qatar participated in this study. At baseline, patients were switched to Gla-100 at the dose chosen by the physician. Oral antidiabetic drugs could also be prescribed. Overall, 440 people were enrolled and 357 were analysed (68.2% men; mean age: 50.5 ? 10.0 years). The primary outcome was the change in HbA1c from baseline to 6 months. Secondary endpoints included the proportion of patients reaching HbA1c target (<7%), insulin dose, weight change and hypoglycaemic events. We found that mean HbA1c levels decreased significantly from 9.3% ? 1.5% to 7.5% ? 0.8% at 6 months (p<0.001). 22.1% of patients achieved HbA1c target <7.0%. Mean daily Gla-100 dose at 6 months was 32.4 ? 10.7 U/day. A mean body weight reduction of 0.75 ? 3.7 kg was observed. Overall, 3.4% of participants (15/380) reported 33 hypoglycemic events. In conclusion, T2DM patients from the Gulf region, inadequately controlled on a premixed insulin regimen may benefit from a switch to a basal insulin strategy with insulin glargine. While improving clinical outcomes in everyday clinical practice, insulin glargine treatment was well tolerated with a low incidence of hypoglycemia and no gain in body weight.