계명대학교 의학도서관 Repository

Initiation of insulin glargine therapy in type 2 diabetes subjects suboptimally controlled on oral antidiabetic agents: results from the AT.LANTUS trial

Metadata Downloads
Author(s)
M. DaviesF. Lavalle-GonzalezF. StormsR. GomisAT.LANTUS Study Group
Keimyung Author(s)
Kim, Hye Soon
Department
Dept. of Internal Medicine (내과학)
Journal Title
Diabetes, Obesity and Metabolism
Issued Date
2008
Volume
10
Issue
5
Abstract
Objective: For many patients with type 2 diabetes, oral antidiabetic agents (OADs) do not provide optimal glycaemic
control, necessitating insulin therapy. Fear of hypoglycaemia is a major barrier to initiating insulin therapy. The
AT.LANTUS study investigated optimal methods to initiate and maintain insulin glargine (LANTUS
Ò
, glargine,
Sanofi-aventis, Paris, France) therapy using two treatment algorithms. This subgroup analysis investigated the initi-
ation of once-daily glargine therapy in patients suboptimally controlled on multiple OADs.
Research Design and Methods: This study was a 24-week, multinational (59 countries), multicenter (611), random-
ized study. Algorithm 1 was a clinic-driven titration and algorithm 2 was a patient-driven titration. Titration was based
on target fasting blood glucose 100 mg/dl ( 5.5 mmol/l). Algorithms were compared for incidence of severe hypo-
glycaemia [requiring assistance and blood glucose <50 mg/dl (<2.8 mmol/l)] and baseline to end-point change in
haemoglobin A
1c
(HbA
1c
).
Results: Of the 4961 patients enrolled in the study, 865 were included in this subgroup analysis: 340 received glargine
plus 1 OAD and 525 received glargine plus >1 OAD. Incidence of severe hypoglycaemia was <1%. HbA
1c
decreased
significantly between baseline and end-point for patients receiving glargine plus 1 OAD (1.4%, p < 0.001; algo-
rithm 1 1.3% vs. algorithm 2 1.5%; p ¼ 0.03) and glargine plus >1 OAD (1.7%, p < 0.001; algorithm 1 1.5%
vs. algorithm 2 1.8%; p ¼ 0.001).
Conclusions: This study shows that initiation of once-daily glargine with OADs results in significant reduction of
HbA
1c
with a low risk of hypoglycaemia. The greater reduction in HbA
1c
was seen in patients randomized to the
patient-driven algorithm (algorithm 2) on 1 or >1 OAD.
Keywords: basal insulin analogues, insulin glargine, oral antidiabetic agents, titration, type 2 diabetes, treatment algorithms
Received 20 August 2007; accepted 8 February 2008
Keimyung Author(s)(Kor)
김혜순
Publisher
School of Medicine
Citation
M. Davies et al. (2008). Initiation of insulin glargine therapy in type 2 diabetes
subjects suboptimally controlled on oral antidiabetic agents:
results from the AT.LANTUS trial. Diabetes, Obesity and Metabolism, 10(5), 387–399. doi: 10.1111/j.1463-1326.2008.00873.x
Type
Article
ISSN
1462-8902
DOI
10.1111/j.1463-1326.2008.00873.x
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35583
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.