IntroductionInsulin analogues have gained widespread popularity. However, in many countries the use of these drugs is limited by their relatively high cost, so there is still a need for more cost-effective human insulin therapies. The aim of the study was to assess the effectiveness and safety of the premixed recombinant human insulin (rhuI) Gensulin M30 in a real-life setting.Material and methodsThe study group consisted of 4257 patients (2196 female, 2061 male) with type 2 diabetes, aged 63.7 ±9.4, with body mass index (BMI) 30.3 ±4.5 kg/m2 and diabetes duration 9 ±5.5 years. All patients were treated with premixed rhuI Gensulin M30. In 91.7% of patients, insulin was used in combination with metformin. In 3.7% of patients, it was used with sulphonylureas. The patients were observed for a period of 6 months.ResultsThe total insulin dose on visit 1 was 36.1 ±18.7 U (0.42 ±0.22 U/kg), and by the end of the study it reached 40.3 ±18.9 U (0.48 ±0.22 U/kg). A significant, continuous decrease of the levels of glycated hemoglobin (HbA1c), along with fasting and postprandial plasma glucose, was observed during the study period. The frequency of hypoglycemia increased slightly during the study, although these figures remained low, especially with regard to severe hypoglycemic episodes (0.02 episodes/patient/year). The lowest number of hypoglycemic episodes occurred in patients treated with insulin and metformin, while the highest number of episodes was observed in patients treated with insulin alone. No weight changes were noted in the patients during the study.ConclusionsThis study shows rhuI Gensulin M30 to be effective and safe in a real-life setting.

Introduction Studies assessing the relationship between glycated haemoglobin (HbA1c) and average blood glucose (ABG) were conducted in small groups of patients on different treatments and may be biased for these reasons. The aim of the study was to assess the relationship between HbA1c and ABG in a large group of type 2 diabetes patients treated with premix insulin. Methods In 4257 patients treated with premixed insulin, the parallel point-of-care assessment of HbA1c and ABG from the preceding 90 days (ABG90), calculated automatically from all values measured by the glucometer, was performed twice. The regression formulas and respective values of HbA1c and ABG90 were calculated. Results The mean number of recorded glucose values/patient was 2.37 estimations per day. The regression formula calculated using data from the first assessment was HbA1c = 5.28 + 0.01487 × ABG90 and that using data from the second one was HbA1c = 4.78 + 0.01683 × ABG90. The slopes of the regression lines are lower than that in a similar analysis from the A1c-Derived Average Glucose (ADAG) study. The comparison of ADAG formula and the formula derived from the present study shows that both formulas give similar results at low HbA1c values, but differ at higher HbA1c values. Additionally, the 95% confidence interval is broader in the PROGENS study e.g. a 95% probability of certainty that the actual HbA1c value was greater than 7.0% (53 mmol/mol) was achieved only at an ABG90 value of 220 mg/dL. Conclusion The relationship between HbA1c and ABG estimations may be different in various patients; therefore, it seems that the use of one equation in all populations may not be reliable. Broad assessment of ABG as a tool that may replace HbA1c measurements should be recommended only with caution, providing the possible limitations and confidence intervals. Funding Bioton S.A.

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Diabetes is a well known risk factor for periodontal and dental diseases. Despite increasing diabetes awareness, up to a third of diabetes cases remain undiagnosed. We assumed that a visit at the dentist’s is an opportunity to assess one’s glucose tolerance. We conducted a nationwide cross-sectional study evaluating whether a dentist can help diagnose diabetes in at-risk subjects. The study was performed between March and June 2017. Thirty dental surgeries across the country participated in the study. Each surgery was given 20 laboratory referral notes for free fasting plasma glucose (FPG) measurement to be handed over to 20 consecutive eligible individuals who gave their consent to take part in the study. The referred patients were asked to perform FPG test during the following 4 weeks. The study inclusion criteria were: age ≥18 years, any degree of any dental or periodontal disease, presence of at least one diabetes risk factor (i.e., BMI ≥25 kg/m2, family history of diabetes, sedentary lifestyle, past gestational diabetes, hypertension, dyslipidemia, cardiovascular disease, policystic ovary syndrome) and negative history of any glucose intolerance. Out of 600 referred patients, 469 (78.2%, 330 [70.4%] women, mean [±SD] age 53.7±15.4 years) had FPG assessed. Mean FPG in all subjects was 97.2±20.9 mg/dl (range 63-377 mg/dl). In 140 subjects (29.9% of those tested and 23.3% of those referred) impaired fasting glucose (IFG; i.e., FPG ≥100 and <126 mg/dl) was diagnosed. 19 subjects had FPG ≥126 mg/dl. IFG subjects were older than those with normal FPG: 60.1±12.6 vs. 50.9±15.7 years (p<0.001), and were more often men (40% vs. 27%; p<0.01). Odds ratio for IFG in subjects aged ≥60 vs. those <60 years was 3.413 (95% CI 2.215-5.264). In conclusion, approx. every fourth patient with at least one diabetes risk factor visiting the dentist’s presents with IFG. Dentists should be concerned about prediabetes particularly in their male patients aged ≥60. Increasing diabetes awareness among the dentists may help diagnose prediabetes and thus further prevent diabetes. Disclosure L. Czupryniak: Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Merck & Co., Inc., Polpharma, Servier. E. Szymanska-Garbacz: Speaker's Bureau; Self; Sanofi, Eli Lilly and Company, Novo Nordisk A/S, Boehringer Ingelheim Pharmaceuticals, Inc., Medtronic MiniMed, Inc., Merck & Co., Inc. P. Bijos: Employee; Self; Teva Pharmaceutical Industries Ltd..