Back to Journals » Pragmatic and Observational Research » Volume 7

Optimizing insulin initiation in primary care: the Diabetes CoStars patient support program

Authors Lutzko O, Schifferle H, Ariola M, Rich A, Meng-Kon K, Palmer H

Received 14 August 2015

Accepted for publication 23 November 2015

Published 28 January 2016 Volume 2016:7 Pages 3—10

DOI https://doi.org/10.2147/POR.S94456

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr RaghunadhaReddy Seelam

Peer reviewer comments 2


Olga K Lutzko,1 Helen Schifferle,2 Marita Ariola,3 Antonia Rich,4 Khen Meng Kon5

1Kardinia Health, GP Super Clinic, Belmont, VIC, 2Medicross Rothwell, Rothwell, QLD, 3Innerwest Specialist Centre, Burwood, NSW, Australia; 4Atlantis Healthcare Pty Ltd, Sydney, Australia; 5Sanofi Australia Pty Ltd, Macquarie Park, NSW, Australia

Purpose: The purpose of this study was to evaluate the optimization of fasting blood glucose (FBG) levels in patients with type 2 diabetes mellitus newly initiated on insulin glargine who were enrolled in the Australian Diabetes CoStars Patient Support Program (PSP).
Patients and methods: A retrospective analysis of data from 514 patients with type 2 diabetes mellitus who completed the 12-week Diabetes CoStars PSP was performed. All patients were initiated on insulin glargine in primary care and enrolled by their general practitioner, who selected a predefined titration plan and support from a local Credentialled Diabetes Educator. The data collected included initial and final insulin dose, self-reported FBG, and glycated hemoglobin (A1c) levels.
Results: The insulin dose increased in 81% of patients. Mean FBG was reduced from 208.8 mg/dL (11.6 mmol/L) to 136.8 mg/dL (7.6 mmol/L) after 12 weeks. Initial and final A1c values were available for 99 patients; mean A1c was reduced from 9.5% (80 mmol/mol) to 8.1% (65 mmol/mol). The reductions in mean FBG and A1c were similar irrespective of titration plan. Overall, 27.2% of patients achieved FBG levels within the titration plan target range of 72–108 mg/dL (4–6 mmol/L) and an additional 43.4% of patients achieved FBG within the range recommended by current Australian guidelines (110–144 mg/dL [6.1–8.0 mmol/L]). Overall, 23.3% of patients achieved the A1c target of ≤7%.
Conclusion: These data demonstrate that the majority of patients enrolled in the Diabetes CoStars PSP achieved acceptable FBG levels 12 weeks after starting insulin therapy irrespective of titration plan.

Keywords: insulin glargine, titration, type 2 diabetes mellitus, fasting blood glucose

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]