TY - JOUR
T1 - Improving glycemic control with insulin detemir using the 303 Algorithm in insulin naïve patients with type 2 diabetes
T2 - A subgroup analysis of the US PREDICTIVE 303 study
AU - Selam, Jean Louis
AU - Koenen, Christoph
AU - Weng, Wayne
AU - Meneghini, Luigi
N1 - Funding Information:
Declaration of interest: This study was supported by Novo Nordisk. JLS is a consultant for Novo Nordisk. LM is a consultant for sanofi-aventis, Novo Nordisk and Medtronic MiniMed, and a member of the speakers bureau for Eli-Lilly, sanofi-aventis, Amylin Pharmaceuticals and Novo Nordisk. CK and WW are affiliated with Novo Nordisk. The authors thank Ming-Ying Chin, MA, for support as a statistical programmer and Dr. Rebecca Shaffer for editorial assistance in the preparation of this manuscript.
PY - 2008/1
Y1 - 2008/1
N2 - Objective: PREDICTIVE 303 was a 26-week, prospective, randomized, open-label, multi-center study in patients with type 2 diabetes that investigated whether patient-driven adjustments of insulin detemir doses using the 303 Algorithm achieved similar glycemic control compared to standard-of-care, physician-driven adjustments in doses. This post hoc sub-analysis evaluates insulin naïve patients on oral anti-diabetic drugs (OADs) who were directed to start on once-daily insulin detemir as add-on therapy to any other glucose-lowering regimens. Methods: Patients in the 303 Algorithm group were instructed to adjust their detemir dose every 3 days based on mean fasting plasma glucose (FPG) values using a simple algorithm: mean FPG < 80 mg/dL, reduce dose by 3 units; between 80-110 mg/dL, no change; > 110 mg/dL, increase by 3 units. Physicians adjusted the detemir dose for patients in the Standard-of-care group according to their usual practice. No control insulin was used for comparison to insulin detemir. Results: Reductions in glycosylated hemoglobin (HbA1c) from baseline were similar between those patients in the 303 Algorithm and Standard-of-care groups (-1.1 and -1.0%, respectively; between group p = 0.0933); patients in the 303 Algorithm group achieved a greater reduction in FPG. Patients in both groups experienced a similar, tow rate of hypoglycemia. Over 95% and 92% of patients, respectively, used detemir once daily. Conclusion: These data indicate that patients with type 2 diabetes naïve to insulin can effectively implement the 303 Algorithm to initiate and adjust a once-daily dose of insulin detemir to achieve improvements in glycemic control.
AB - Objective: PREDICTIVE 303 was a 26-week, prospective, randomized, open-label, multi-center study in patients with type 2 diabetes that investigated whether patient-driven adjustments of insulin detemir doses using the 303 Algorithm achieved similar glycemic control compared to standard-of-care, physician-driven adjustments in doses. This post hoc sub-analysis evaluates insulin naïve patients on oral anti-diabetic drugs (OADs) who were directed to start on once-daily insulin detemir as add-on therapy to any other glucose-lowering regimens. Methods: Patients in the 303 Algorithm group were instructed to adjust their detemir dose every 3 days based on mean fasting plasma glucose (FPG) values using a simple algorithm: mean FPG < 80 mg/dL, reduce dose by 3 units; between 80-110 mg/dL, no change; > 110 mg/dL, increase by 3 units. Physicians adjusted the detemir dose for patients in the Standard-of-care group according to their usual practice. No control insulin was used for comparison to insulin detemir. Results: Reductions in glycosylated hemoglobin (HbA1c) from baseline were similar between those patients in the 303 Algorithm and Standard-of-care groups (-1.1 and -1.0%, respectively; between group p = 0.0933); patients in the 303 Algorithm group achieved a greater reduction in FPG. Patients in both groups experienced a similar, tow rate of hypoglycemia. Over 95% and 92% of patients, respectively, used detemir once daily. Conclusion: These data indicate that patients with type 2 diabetes naïve to insulin can effectively implement the 303 Algorithm to initiate and adjust a once-daily dose of insulin detemir to achieve improvements in glycemic control.
KW - Insulin detemir
KW - Insulin titration
KW - Insulin-naïve
KW - Long-acting insulin analog
KW - PREDICTIVE 303
KW - Type 2 diabetes
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U2 - 10.1185/030079907X242755
DO - 10.1185/030079907X242755
M3 - Article
C2 - 18021495
AN - SCOPUS:38549131326
SN - 0300-7995
VL - 24
SP - 11
EP - 20
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
IS - 1
ER -