Starting patients on insulin with or without oral anti-hyperglycemic medication is linked to suboptimal glycemic control in the short- and long-term, according to an observational, retrospective longitudinal analysis involving more than 40,000 individuals.

Participants were insulin-naïve, aged ≥30 years, and had type 2 diabetes. Investigators looked at the factors occurring 0 to 3 months after initiating insulin that correlated with glycemic control after that time. Among the results:

• 2 in every 10 patients achieved HbA1c of ≤7% at 3 months; more than one-fourth achieved such at 2 years.
• Those who failed to reach the target HbA1c at 3 months were nearly 4 times more likely to miss the target at 2 years.
• Nearly 1 in every 10 patients experienced a recorded hypoglycemic event over 2 years.
• Patients who experienced hypoglycemia within the first 3 months were nearly 6 times more likely to have such an event later.