Those starting with lower A1C levels more likely to achieve A1C goal within five months….
Less than half of newly diagnosed patients with type 2 diabetes achieve an A1C less than 7 percent, and those that do achieve it more likely started with lower A1C levels, according to a study published in the March issue of Diabetes Care.
Gregory A. Nichols, Ph.D., from the Kaiser Permanente Center for Health Research in Portland, Ore., and colleagues studied 1,139 patients with type 2 diabetes who initiated insulin therapy between January 2009 and June 2010.
The researchers found that mean A1C at insulin initiation was 8.2 percent in those who subsequently achieved A1C <7 percent, compared with 9.2 percent among those who did not. Within a mean of five months, 464 patients (40.7 percent) attained A1C <7 percent. When controlling for insulin regimen, dose, and oral agent use, preinsulin A1C was responsible for nearly all the explained variance in A1C change. Each one percentage point of preinsulin A1C reduced the probability of achieving A1C <7 percent by 26 percent (odds ratio, 0.74).
“Insulin initiation at lower levels of A1C improves goal attainment and independently increases glycemic response,” the authors write.
Diabetes Care March 2012 vol. 35 no. 3 495-497