Characteristics of patients with type 2 diabetes mellitus initiating insulin therapy: baseline data from the INSTIGATE study*.

ABSTRACTObjective:To describe the characteristics at baseline of patients with type 2 diabetes mellitus who are initiating insulin.Methods:Prospective, observational multi-centre, open-label study in five European countries of patients with type 2 diabetes who were initiating insulin as part of their usual care.Results:A total of 1172 patients were enrolled, with mean age 63.3 years and body mass index 29.9 kg/m2. The majority (90) of patients were taking one or more oral anti-diabetic agents; the percentage not taking anti-diabetic medication in the previous four weeks was highest in Germany (23.4) and Spain (15.1). The prevalence of microvascular diseases (range: 16.1–36.1) varied considerably between countries but for macrovascular (30.4–38.6) and other diabetes-related diagnoses (72.6–76.6) such as hypertension and dyslipidaemia the differences were less pronounced. In Germany, reported use of lipid-lowering (26.7) and anti-platelet (27.1) therapies was much less than in other countries (ranges: 53.2–78.1 and 48.3–61.1, respectively). The majority of evaluable patients in each country had demonstrated poor control over a long period of time. Prior to initiating insulin, the most recent mean (±SD) HbA1cwas 9.58 ± 1.81, fasting plasma glucose was 12.18 ± 4.32 mmol/L and 78.5 had metabolic syndrome. IDF targets for HDL- and LDL-cholesterol, and blood pressure were met in 76.8, 33.1 and 18.9 of patients, respectively.Conclusions:Insulin treatment was only initiated after HbA1cvalues were considerably higher than recommended in treatment guidelines for a sustained period of time. [ABSTRACT FROM AUTHOR]