Achieving Glycemic Goals in Type 2 Diabetes

Glycaemic control among patients with type 2 diabetes mellitus in seven European countries: findings from the Real‐Life Effectiveness and Care Patterns of Diabetes Management (RECAP‐DM) study

“…In this study of European patients with T2DM, 26% of patients had adequate glycaemic control (HbA1C < 6.5%) a mean of 2.6 years combination AHA therapies were started. The findings in general extend conclusions from many prior studies showing that most patients with diabetes are not treated to consensus HbA1C targets [12]. The proportion of patients with adequate glycaemic control in this study was somewhat lower than the 31% of those with a target HbA1C < 6.5% observed in the European CODE‐2 study [8].…”

Clinical outcomes after 24 months of insulin therapy in patients with type 2 diabetes in five countries: results from the TREAT study

“…High mean baseline HbA 1c levels were also observed in INSTIGATE 15 and other observational studies 8,[16][17][18][19][20] , indicating a delay in starting insulin therapy that could be caused by resistance to insulin initiation by patients and healthcare providers 21 . In this study as well as in INSTIGATE 9 , the mean HbA 1c level of patients who initiated on long/intermediate insulin regimens was lower than those who initiated on mixtures or basal-bolus regimens, as also recommended in the IDF and ADA-EASD guidelines.…”

“…However, the majority of patients do not achieve glycaemic goals in routine clinical practice 7,8 . Among the challenges is the appropriate management of insulin therapy through insulin initiation and intensification.…”

Dipeptidyl Peptidase-4 Inhibitors Administered in Combination With Metformin Result in an Additive Increase in the Plasma Concentration of Active GLP-1

“…1,2 The Diabetes Control and Complications Trial (DCCT) 3 and the United Kingdom Prospective Diabetes Study (UKPDS) 4 have shown that intensive treatment of hyperglycemia reduces the incidence of disease-related microvascular complications (e.g., retinopathy and nephropathy). Many patients with T2DM, however, do not achieve recommended glycemic treatment goals with monotherapy 5 and require a combination of oral antihyperglycemic agents. 6,7 The recent introduction of dipeptidyl peptidase-4 (DPP-4) inhibitors [8][9][10] has attracted considerable interest, particularly given that the existing treatments have inadequate efficacy and durability and/or are associated with significant side effects.…”