Trajectory of glycated haemoglobin over time, using real‐world data, in type 2 diabetes patients with obesity on a U‐100 basal‐bolus insulin regimen
Authors' conclusion
The present study found the potential for therapeutic inertia among a significant proportion of T2DM patients with obesity on basal-bolus insulin. Subgrouping T2DM patients based on HbA1c missingness and HbA1c trajectories can inform disease management strategies.
Study context
- Population
- T2D patients with obesity on basal-bolus insulin, Veterans' Health Administration database
- Participants
- 51,273 patients
- Exposure
- Stable low vs Stable high vs Descending low vs Ascending low vs Descending high vs Ascending high
- Outcome
- HbA1c trajectory clusters, structured at 6-month intervals
- Follow-up
- 3-year period
Methodological detailsreal-world data, unsupervised clustering, multinomial logistic regression
- Real-world data
- Unsupervised clustering
- Multinomial logistic regression
Main finding
As reported in the abstract
HbA1c trajectory clusters (patients with sufficient HbA1c observations) · 3 years
- Persistent missingness of HbA1c values
- 11.2%
Observational data: associations, not effects.
Further findings
- Black ethnicity, not initiating noninsulin antihyperglycaemic agents (SGLT2i, GLP-1 RA or TZD) or concentrated insulin, low adherence (proportion of days covered) and reduced insulin refills were associated with poorer HbA1c clusters; similar factors with persistent HbA1c missingness
Original publication
Trajectory of glycated haemoglobin over time, using real‐world data, in type 2 diabetes patients with obesity on a U‐100 basal‐bolus insulin regimen. Diabetes Obes Metab. Published 23 March 2023. doi:10.
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