Longitudinal change in HbA1c after insulin initiation in primary care patients with type 2 diabetes: A database analysis in UK and Germany

AimsTo evaluate the 3-year change in HbA1c values after start of insulin therapy among patients with type 2 diabetes in primary care practices in UK and Germany.MethodsLongitudinal data from general practices in Germany and UK (Disease Analyser, IMS HEALTH) from 2005 to 2009 were analysed, including 779 patients (mean age ± SD: 63 ± 11 yrs, HbA1c: 8.1 ± 1.3%) in Germany and 646 patients (55 ± 12 yrs; 9.3 ± 1.5%) in UK with first time insulin prescriptions in 2005 (index date). The mean individual relative changes in HbA1c over 3 years after index date were adjusted for age, sex, diabetes duration, oral antidiabetics, insulin type, comorbidity and visits using general linear models.ResultsThe average adjusted HbA1c improvements in the first 12 months in primary care patients were 0.5% (95%CI: 0.4–0.6%) in Germany and 1.0% (0.7–1.3%) in UK. Between 12 and 36 months these improvements in glycemic control were maintained in both patient groups.DiscussionInitiation of insulin therapy in primary care patients in Germany and UK was associated with a similar moderate improvement in glycemic control over the first 12 months. After this period, insulin therapy only maintained HbA1c values without additional improvement in glycemic control.