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