Aims: We present final Hellenic data from the INSTIGATE study which assessed direct costs, resource utilisation, and clinical outcomes in the first 24 months of insulin therapy in type 2 diabetic (T2D) patients.
Methods: INSTIGATE was a prospective European observational study of patients with type 2 diabetes who had initiated insulin during usual care. Data were collected at baseline, when subjects initiated insulin (visit T1), then 3 (T2), 6 (T3), 12 (T4), 18 (T5) and 24 months (T6) later.
Results: The data presented here is for the 237 patients with Baseline, 6 and 12 month visits; at 18 and 24 months data were available from 229 and 227 patients respectively.
Following insulin initiation mean HbA1c improved from (SD) 9.65(1.63)% at baseline to 7.44(1.06)%, 7.39(1.15)%, 7.28(0.96)% and 7.14(0.85)% at 6, 12, 18 and 24 months respectively. Mean fasting blood glucose (FBG) improved from (SD) 12.8(3.9) mmol/l to 7.8(2.2) mmol/l, 7.8(2.4) mmol/l, 7.5(2.1) mmol/l and 7.3(2.1) mmol/l over the same period. Mean BMI (SD) was 28.2(4.7) kg/m2 at baseline up to 29.4(4.6) kg/m2 at 24 months. Patients reporting at least one hypoglycaemic episode were 3.0% (in the three months prior to insulin initiation) 29.1% (in the six months after initiation) and above 20% thereafter. Health status, measured by EQ-5D visual analogue scale score, improved from baseline to 6, 12, 18 and 24 months, the highest improvement being from baseline up to 6 months after insulin initiation.
Conclusions: Greek patients initiated insulin when HbA1c is by much higher than recommended by international guidelines; yet their glycaemic control improved in the 6 months following initiation, the best improvement being observed from baseline to 6 months. Mean health-related quality-of-life scores also improved, however there was an increase in the number of patients reporting hypoglycaemia.
Declaration of interest: I fully declare a conflict of interest. Details below
Funding: This work was supported, however funding details unavailable.