Programme « L&Vous » : élaboration d'une charte de bonne utilisation de l'insuline basale chez le patient diabétique de type 2

The optimal use of basal insulin is a key determinant of the therapeutic success of insulin therapy in type 2 diabetes (T2D). Up to now it remains relatively underexplored. The “L&Vous” program aims to fill this need via a global approach of patients' health in France. We describe here the first stage of the program: the development and validation of a charter of optimal use (COU) of basal insulin in patients with T2D, combining the opinions of diabetologists and patients. A working group produced a first draft of the COU. This draft was submitted for exchange and amendments to a wide range of French diabetologists having diverse clinical settings. The French Association of Diabetic Patients made a further and additional analysis and refinements of the draft. A total of 500 diabetologists and other Health Care Providers (HCP) participated in the final document. Two thirds of the participants declared a “complete or overall agreement” with the COU. This charter includes 10 items regarding the key requirements for an optimal use of basal insulin as: autonomy for insulin injection and titration, knowledge of glycemic targets, blood glucose monitoring, management of hypoglycemia, educational approach for better quality of life… Patients' opinion was found concordant with that of HCP, but with small improvements as on lifestyle and dietary rules adapted to insulin use. In conclusion, the COU has aroused a great interest among HCP and patients. This should allow the second step of “L&Vous” program: the implementation of this COU to evaluate, on a large scale, basal insulin use in “Real Life” by T2D patients in France. Early trends of the observatory are discussed here; the full results will be published soon in a second article.