Treatment intensification with insulin glargine in patients with inadequately controlled type 2 diabetes improves glycaemic control with a high treatment satisfaction and no weight gain

PRINCIPLES: We aimed to evaluate the efficacy of, and treatment satisfaction with, insulin glargine administered with SoloSTAR (R) or ClikSTAR (R) pens in patients with type 2 diabetes mellitus managed by primary care physicians in Switzerland. METHODS: A total of 327 patients with inadequately controlled type 2 diabetes were enrolled by 72 physicians in this prospective observational study, which aimed to evaluate the efficacy of a 6-month course of insulin glargine therapy measured as development of glycaemic control (glycosylated haemoglobin [HbA(1c)] and fasting plasma glucose [FPG]) and weight change. We also assessed preference for reusable or disposable pens, and treatment satisfaction. RESULTS: After 6 months, the mean daily dose of insulin glargine was 27.7 +/- 14.3 U, and dose titration was completed in 228 (72.4%) patients. Mean HbA1c decreased from 8.9% +/- 1.6% (n = 327) to 7.3% +/- 1.0% (n = 315) (p < 0.0001), and 138 (43.8%) patients achieved an HbA(1c) = 7.0%. Mean FPG decreased from 10.9 +/- 4.5 to 7.3 +/- 1.8 mmol/l (p < 0.0001). Mean body weight did not change (85.4 +/- 17.2 kg vs 85.0 +/- 16.5 kg; p = 0.11). Patients' preference was in favour of the disposable SoloStar (R) pen (80%), as compared with the reusable ClickStar (R) pen (20%). Overall, 92.6% of physicians and 96.3% of patients were satisfied or very satisfied with the insulin glargine therapy. CONCLUSIONS: In patients with type 2 diabetes insulin glargine administered by SoloSTAR (R) or ClikSTAR (R) pens, education on insulin injection and on self-management of diabetes was associated with clinically meaningful improvements in HbA1c and FPG without a mean collective weight gain. The vast majority of both patients and primary care physicians were satisfied with the treatment intensification.