Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Helping patients to titrate to the right insulin dosage improves fasting blood glucose irrespective of the titration regimen chosen: Real world insights from a patient support program (#330)

Olga Lutzko 1 , Helen Schifferle 2 , Marita Ariola 3 , Antonia Rich 4 , Khen Meng-Kon 5
  1. Kardina Health, GP Super Clinic, Belmont, VIC, Australia
  2. Medicross Rothwell, Rothwell, QLD, Australia
  3. Innerwest Specialist Centre, Burwood, NSW, Australia
  4. Atlantis Healthcare, North Ryde, NSW, Australia
  5. Sanofi Australia Pty Ltd, Maquarie Park, NSW, Australia

The Diabetes CoStars Patient Support Program is designed to assist fasting blood glucose (FBG) optimisation in patients with type 2 diabetes mellitus newly initiated on insulin glargine. Enrolled patients are assigned to one of three titration regimens (Table) by their physician, provided with support materials and free sessions with a local Credentialled Diabetes Educator (CDE).

We retrospectively analysed data from 514 patients who had completed the 12-week program. Patients were evenly distributed between the titration regimens.

Primary analysis: Mean FBG at enrollment into the program was 11.6mmol/L. By week-12, this had fallen, on average, by 3.99mmol/L. By week 12, 27% of patients had achieved the tight target FBG of 4-6mmol/L (normoglycaemia) and 43.4% had achieved the less stringent NHMRC target FBG of 6.1-8.0mmol/L. The odds of achieving FBG target were the same irrespective of the titration regimen chosen.

Secondary analyses: The mean insulin dose at initiation was 20.7±20IU. Over the course of the program, there was an overall increase of 11.5±15.9IU in mean insulin dose. Collection of HbA1c values was not mandatory; start/finish HbA1c values were available for 99 patients, in whom there was a mean fall of 1.28±1.6%. Overall 27/116 (23%) patients with a result for final HbA1c had achieved target at the end of the program.

This real world data demonstrates that glycaemic control can be improved with provision of a titration plan plus access to a CDE. This has the potential to improve overall care.

Funding: This program, data analysis and abstract editorial support were funded by Sanofi Australia Pty Ltd. 

1533-costars.png*Protocol FBG target 4-6mmol/L; †NHMRC FBG target 6.1-8.0mmol/L; SEM = standard error of the mean.