2193-PUB: Effect of One Month Basal Insulinization in Addition to OADs Initiation on Glycemic Parameters in Newly Diagnosed Treatment-Naïve Type 2 Diabetes Patients Presenting with Osmotic Symptoms or Glucotoxicity: A Long-Term Follow-Up Study

Aim: To assess the glycemic outcomes of early basal insulin therapy in newly diagnosed treatment naïve T2DM patients presenting with glucotoxicity.

Methods: A cross-sectional observational retrospective data analysis of T2DM patients visiting diabetes specialty clinic across India from January 2016 to October 2019. Patients initiated on basal insulin for one month along with oral antidiabetes drugs were included in the analysis. The demographic, clinical, and glycemic investigations data were collected from electronic medical records. Patients were followed up for at least 4 clinic visits at 3 months interval.

Results: Total 527 newly diagnosed T2DM patients were included. Males: 352 (67%) and females were 175 (33%). Mean age was 50.5 years and BMI was 27.7 kg/m2. Patients glycemic parameters at the time of initiation of insulin therapy were highly uncontrolled, their mean HbA1c, FBG, and PPBG were 10.9%, 236 mg/dL and 335 mg/dL. Among these patients, only 87 patients regularly followed up to clinic for a year. The average follow-up time period was 250 days. These patients’ glycemic parameter reduced significantly from baseline through last follow up visit. HbA1c reduced from 12.2% to 7.5%; FBG 270 mg/dL to 135mg/dL; PPBG 370 mg/dL to 181 mg/dL (p <0.001). Further, there was clinically significant improvement in the lipid profile of these patients. In addition, TC 199 to 151 mg/dL; TG 222 to 161 mg/dL; low density lipoprotein 122 to 81 mg/dL were also reduced.

Conclusions: Early initiation of basal insulin therapy has shown to reduce glycemic burden and the disease progression suggesting early insulinization should be the treatment option for effective control of diabetes and long term benefits in avoiding the complications. This is even supported by international guidelines as part of an individualized approach to chronic disease management.