DOSE TITRATION AND GLYCEMIC CONTROL WITH INSULIN GLARGINE 100 U/ML IN PREVIOUSLY UNCONTROLLED PATIENTS WITH TYPE 2 DIABETES: A 6-MONTH PROSPECTIVE OBSERVATIONAL STUDY IN PRIMARY CARE IN LEBANON.

Objective:the rapid increase in diabetes prevalence in lebanon is alarming, with 14.5% of the population affected in 2013. Early and adequate use of individualized insulin treatment strategies is effective to prevent or delay the onset of long-term complications. This study aimed at exploring the effectiveness of insulin glargine 100 u/ml (gla-100)-based strategies initiated at the discretion of primary care physicians (pcps) in people with type 2 diabetes mellitus uncontrolled on oral antidiabetic drugs (oads). Research design and methods: in this national, multicenter, prospective study, 601 patients with previously uncontrolled type 2 diabetes and prescribed gla-100 were enrolled. Glycated hemoglobin (hba1c), fasting plasma glucose (fpg) and the changes in treatment schemes to reach control were analyzed after three and six months. Safety data were also reported. Results:the majority (85%) of patients were overweight or obese, and over 30% had diabetes complications. About 60% of patients used a self-titration scheme and reported adherence to gla-100 therapy at both study visits. Hba1c decreased from 9.8 ? 1.3% (84 mmol/mol) to 7.1 ? 0.9% (54 mmol/mol) from baseline to 6 months (p<0.0001). Similarly, fpg levels significantly improved. People lost body weight of 1.7 kg at 6 months and only 1.4% reported minor hypoglycemic episodes. Conclusion:this study demonstrated that introduction of gla-100 to type 2 diabetes patients uncontrolled on oad therapy significantly improved glycemic control with low risk of hypoglycemia and no weight gain. In addition, the study indicated that pcps in lebanon were successful in managing type 2 diabetes and monitoring patients? self-titration schemes.