{"title":"Insulin initiation for patients with poorly controlled type 2 diabetes mellitus.","authors":"Hsin-An Chen, Chia-Hung Lin, Feng-Hsuan Liu","doi":"10.1097/JCMA.0000000000001232","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We examined the initiation of insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM), analyzed their glycemic responses, and compared patient profiles based on glycemic outcomes.</p><p><strong>Method: </strong>Patients with T2DM initiated on insulin therapy were retrospectively analyzed. Data were collected from endocrinology clinic before and 3- and 6-months after insulin initiation. The primary outcome was hemoglobin A1c (HbA1c) level 6 months after commencing insulin treatment. Secondary outcomes included HbA1c levels at 3 months after insulin treatment and fasting blood glucose levels at 3 and 6 months after treatment. We analyzed the effects of insulin initiation and categorized patients based on their 6-month HbA1c levels: below the median of 7.8% (better response) and above 7.8% (worse response). Additionally, we evaluated patients based on HbA1c changes at 6 months, with greater or lesser changes defined by the cohort's median change of -1.4%.</p><p><strong>Result: </strong>Insulin therapy significantly reduced HbA1c (from 9.8% to 8.2%) and fasting blood glucose levels (from 221.4 to 147.2 mg/dL) within 3 months. After 6 months, HbA1c and fasting blood glucose levels decreased by 2.1% (9.8-7.7%) and 77.2 mg/dL (221.4-144.2 mg/dL), respectively. Patients who responded better to insulin treatment showed lower fasting blood glucose levels by 6 months after insulin initiation and lower HbA1c levels as soon as 3 months after initiation. Patients with higher baseline glycemic profiles experienced significantly greater HbA1c reductions at 6 months post-treatment.</p><p><strong>Conclusion: </strong>Insulin therapy significantly improved glycemic control in patients with T2DM within 3 months after initiation. Patients with higher baseline glycemic profiles experienced greater responses to insulin therapy.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Chinese Medical Association : JCMA","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/JCMA.0000000000001232","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: We examined the initiation of insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM), analyzed their glycemic responses, and compared patient profiles based on glycemic outcomes.
Method: Patients with T2DM initiated on insulin therapy were retrospectively analyzed. Data were collected from endocrinology clinic before and 3- and 6-months after insulin initiation. The primary outcome was hemoglobin A1c (HbA1c) level 6 months after commencing insulin treatment. Secondary outcomes included HbA1c levels at 3 months after insulin treatment and fasting blood glucose levels at 3 and 6 months after treatment. We analyzed the effects of insulin initiation and categorized patients based on their 6-month HbA1c levels: below the median of 7.8% (better response) and above 7.8% (worse response). Additionally, we evaluated patients based on HbA1c changes at 6 months, with greater or lesser changes defined by the cohort's median change of -1.4%.
Result: Insulin therapy significantly reduced HbA1c (from 9.8% to 8.2%) and fasting blood glucose levels (from 221.4 to 147.2 mg/dL) within 3 months. After 6 months, HbA1c and fasting blood glucose levels decreased by 2.1% (9.8-7.7%) and 77.2 mg/dL (221.4-144.2 mg/dL), respectively. Patients who responded better to insulin treatment showed lower fasting blood glucose levels by 6 months after insulin initiation and lower HbA1c levels as soon as 3 months after initiation. Patients with higher baseline glycemic profiles experienced significantly greater HbA1c reductions at 6 months post-treatment.
Conclusion: Insulin therapy significantly improved glycemic control in patients with T2DM within 3 months after initiation. Patients with higher baseline glycemic profiles experienced greater responses to insulin therapy.