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Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017

  • Lee, Byung-Wan (Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Jin Hwa (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chosun University College of Medicine) ;
  • Ko, Seung-Hyun (Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Hur, Kyu Yeon (Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Nan-Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine) ;
  • Rhee, Sang Youl (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Kim, Hyun Jin (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Moon, Min Kyong (Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center) ;
  • Park, Seok-O (Department of Internal Medicine, Gwangmyeong Sungae Hospital) ;
  • Choi, Kyung Mook (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine) ;
  • Committee of Clinical Practice Guideline of Korean Diabetes Association (Korean Diabetes Association)
  • Received : 2017.09.08
  • Accepted : 2017.10.14
  • Published : 2017.11.01

Abstract

The Korean Diabetes Association (KDA) has regularly updated its Clinical Practice Guidelines. In 2017, the KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). Growing evidence from new multinational clinical trials using novel and traditional insulin analogues has also been accumulated. Following global trends, many results of clinical trials, especially concerning the clinical efficacy and safety of insulin therapy, have been published about Korean patients with T2DM. After a systematic search of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the initiation, choice, and intensification of insulin and created an insulin treatment algorithm for the first time to guide physicians caring for adult Korean patients with T2DM.

Keywords

References

  1. Turner RC, Cull CA, Frighi V, Holman RR. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 1999;281:2005-2012. https://doi.org/10.1001/jama.281.21.2005
  2. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract 1995;28:103-117. https://doi.org/10.1016/0168-8227(95)01064-K
  3. Weng J, Li Y, Xu W, et al. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicenter randomised parallel-group trial. Lancet 2008;371:1753-1760. https://doi.org/10.1016/S0140-6736(08)60762-X
  4. Yoo HJ, Park KY, Park KS, et al. Safety and efficacy of modern insulin analogues. Diabetes Metab J 2013;37:181-189. https://doi.org/10.4093/dmj.2013.37.3.181
  5. Hwang YC, Kang JG, Ahn KJ, et al. The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub-analysis from the A(1)chieve((R)) study. Int J Clin Pract 2014;68:1338-1344. https://doi.org/10.1111/ijcp.12482
  6. Yang Y, Shin JA, Yang HK, et al. Reduction of sulfonylurea with the initiation of basal insulin in patients with inadequately controlled type 2 diabetes mellitus undergoing long-term sulfonylurea-based treatment. Diabetes Metab J 2016;40:454-462. https://doi.org/10.4093/dmj.2016.40.6.454
  7. Kim SS, Kim IJ, Kim YK, et al. Insulin initiation in insulin- naive Korean type 2 diabetic patients inadequately controlled on oral antidiabetic drugs in real-world practice: the modality of insulin treatment evaluation study. Diabetes Metab J 2015;39:481-488. https://doi.org/10.4093/dmj.2015.39.6.481
  8. Choi SH, Oh TJ, Jang HC. Comparison of antidiabetic regimens in patients with type 2 diabetes uncontrolled by combination therapy of sulfonylurea and metformin: results of the MOHAS disease registry in Korea. Diabetes Metab J 2017;41:170-178. https://doi.org/10.4093/dmj.2017.41.3.170
  9. Malmberg K, Norhammar A, Wedel H, Ryden L. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study. Circulation 1999;99:2626-2632. https://doi.org/10.1161/01.CIR.99.20.2626
  10. Yong YM, Shin KM, Lee KM, et al. Intensive individualized reinforcement education is important for the prevention of hypoglycemia in patients with type 2 diabetes. Diabetes Metab J 2015;39:154-163. https://doi.org/10.4093/dmj.2015.39.2.154
  11. Horvath K, Jeitler K, Berghold A, et al. Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst Rev 2007;(2):CD005613.
  12. Holman RR, Thorne KI, Farmer AJ, et al. Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes. N Engl J Med 2007;357:1716-1730. https://doi.org/10.1056/NEJMoa075392
  13. Holman RR, Farmer AJ, Davies MJ, et al. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med 2009;361:1736-1747. https://doi.org/10.1056/NEJMoa0905479
  14. Giugliano D, Maiorino MI, Bellastella G, Chiodini P, Ceriello A, Esposito K. Efficacy of insulin analogs in achieving the hemoglobin A1c target of <7% in type 2 diabetes: meta-analysis of randomized controlled trials. Diabetes Care 2011;34:510-517. https://doi.org/10.2337/dc10-1710
  15. Yki-Jarvinen H, Rosenstock J, Duran-Garcia S, et al. Effects of adding linagliptin to basal insulin regimen for inadequately controlled type 2 diabetes: a ${\geq}$52-week randomized, double-blind study. Diabetes Care 2013;36:3875-3881. https://doi.org/10.2337/dc12-2718
  16. Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c). Diabetes Care 2003;26:881-885. https://doi.org/10.2337/diacare.26.3.881
  17. Aschner P, Sethi B, Gomez-Peralta F, et al. Insulin glargine compared with premixed insulin for management of insulin- naive type 2 diabetes patients uncontrolled on oral antidiabetic drugs: the open-label, randomized GALAPAGOS study. J Diabetes Complications 2015;29:838-845. https://doi.org/10.1016/j.jdiacomp.2015.04.003
  18. Lee YH, Lee BW, Chun SW, Cha BS, Lee HC. Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure. Int J Clin Pract 2011;65:1076-1084. https://doi.org/10.1111/j.1742-1241.2011.02755.x
  19. Douek IF, Allen SE, Ewings P, Gale EA, Bingley PJ; Metformin Trial Group. Continuing metformin when starting insulin in patients with type 2 diabetes: a double-blind randomized placebo-controlled trial. Diabet Med 2005;22:634-640. https://doi.org/10.1111/j.1464-5491.2005.01475.x
  20. Suk JH, Lee CW, Son SP, et al. Current status of prescription in type 2 diabetic patients from general hospitals in Busan. Diabetes Metab J 2014;38:230-239. https://doi.org/10.4093/dmj.2014.38.3.230
  21. Fonseca V, Gill J, Zhou R, Leahy J. An analysis of early insulin glargine added to metformin with or without sulfonylurea: impact on glycaemic control and hypoglycaemia. Diabetes Obes Metab 2011;13:814-822. https://doi.org/10.1111/j.1463-1326.2011.01412.x
  22. Park CY, Kang JG, Chon S, et al. Comparison between the therapeutic effect of metformin, glimepiride and their combination as an add-on treatment to insulin glargine in uncontrolled patients with type 2 diabetes. PLoS One 2014;9:e87799. https://doi.org/10.1371/journal.pone.0087799
  23. Charbonnel B, DeFronzo R, Davidson J, et al. Pioglitazone use in combination with insulin in the prospective pioglitazone clinical trial in macrovascular events study (PROactive19). J Clin Endocrinol Metab 2010;95:2163-2171. https://doi.org/10.1210/jc.2009-1974
  24. Clar C, Royle P, Waugh N. Adding pioglitazone to insulin containing regimens in type 2 diabetes: systematic review and meta-analysis. PLoS One 2009;4:e6112. https://doi.org/10.1371/journal.pone.0006112
  25. Hong ES, Khang AR, Yoon JW, et al. Comparison between sitagliptin as add-on therapy to insulin and insulin dose-increase therapy in uncontrolled Korean type 2 diabetes: CSI study. Diabetes Obes Metab 2012;14:795-802. https://doi.org/10.1111/j.1463-1326.2012.01600.x
  26. Kothny W, Foley J, Kozlovski P, Shao Q, Gallwitz B, Lukashevich V. Improved glycaemic control with vildagliptin added to insulin, with or without metformin, in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2013;15:252-257. https://doi.org/10.1111/dom.12020
  27. Devineni D, Morrow L, Hompesch M, et al. Canagliflozin improves glycaemic control over 28 days in subjects with type 2 diabetes not optimally controlled on insulin. Diabetes Obes Metab 2012;14:539-545. https://doi.org/10.1111/j.1463-1326.2012.01558.x
  28. Rosenstock J, Jelaska A, Frappin G, et al. Improved glucose control with weight loss, lower insulin doses, and no increased hypoglycemia with empagliflozin added to titrated multiple daily injections of insulin in obese inadequately controlled type 2 diabetes. Diabetes Care 2014;37:1815-1823. https://doi.org/10.2337/dc13-3055
  29. Wilding JP, Woo V, Soler NG, et al. Long-term efficacy of dapagliflozin in patients with type 2 diabetes mellitus receiving high doses of insulin: a randomized trial. Ann Intern Med 2012;156:405-415. https://doi.org/10.7326/0003-4819-156-6-201203200-00003
  30. Min SH, Yoon JH, Hahn S, Cho YM. Comparison between SGLT2 inhibitors and DPP4 inhibitors added to insulin therapy in type 2 diabetes: a systematic review with indirect comparison meta-analysis. Diabetes Metab Res Rev 2017;33:e2818. https://doi.org/10.1002/dmrr.2818
  31. Ko SH, Hur KY, Rhee SY, et al. Antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus 2017: a position statement of the Korean Diabetes Association. Diabetes Metab J 2017;41:337-348. https://doi.org/10.4093/dmj.2017.41.5.337
  32. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2015;38:140-149. https://doi.org/10.2337/dc14-2441
  33. Diamant M, Nauck MA, Shaginian R, et al. Glucagon-like peptide 1 receptor agonist or bolus insulin with optimized basal insulin in type 2 diabetes. Diabetes Care 2014;37:2763-2773. https://doi.org/10.2337/dc14-0876
  34. Eng C, Kramer CK, Zinman B, Retnakaran R. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet 2014;384:2228-2234. https://doi.org/10.1016/S0140-6736(14)61335-0
  35. Yoon KH, Hardy E, Han J. Exenatide versus insulin lispro added to basal insulin in a subgroup of Korean patients with type 2 diabetes mellitus. Diabetes Metab J 2017;41:69-74. https://doi.org/10.4093/dmj.2017.41.1.69
  36. Raccah D, Bretzel RG, Owens D, Riddle M. When basal insulin therapy in type 2 diabetes mellitus is not enough: what next? Diabetes Metab Res Rev 2007;23:257-264. https://doi.org/10.1002/dmrr.733
  37. Giugliano D, Chiodini P, Maiorino MI, Bellastella G, Esposito K. Intensification of insulin therapy with basal- bolus or premixed insulin regimens in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Endocrine 2016;51:417-428. https://doi.org/10.1007/s12020-015-0718-3
  38. Dieuzeide G, Chuang LM, Almaghamsi A, Zilov A, Chen JW, Lavalle-Gonzalez FJ. Safety and effectiveness of biphasic insulin aspart 30 in people with type 2 diabetes switching from basal-bolus insulin regimens in the A1chieve study. Prim Care Diabetes 2014;8:111-117. https://doi.org/10.1016/j.pcd.2013.07.005
  39. Mathieu C, Storms F, Tits J, Veneman TF, Colin IM. Switching from premixed insulin to basal-bolus insulin glargine plus rapid-acting insulin: the ATLANTIC study. Acta Clin Belg 2013;68:28-33. https://doi.org/10.2143/ACB.68.1.2062716

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