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The Diabetes Unmet Need with basal insulin Evaluation (DUNE) study in type 2 diabetes: Achieving HbA 1c targets with basal insulin in a real-world setting.

AIMS: To describe in a real-world setting the achievement of physician-selected individualized HbA1c targets in people with type 2 diabetes, newly or recently initiated on basal insulin, and the association of hypoglycemia with target achievement.

MATERIALS AND METHODS: A 12-week, prospective, single-arm, observational study of adults with type 2 diabetes either newly initiated with any basal insulin or started on basal insulin within the preceding 12 months. At enrollment, eligible participants from 28 countries were treated with or without oral antihyperglycemic drugs and/or GLP-1 receptor agonists.

RESULTS: Almost all 3139 evaluable participants (99.7%) had been set individualized targets by their physicians, with 57% of participants having HbA1c targets between 7.0 and <7.5 %. (53 and <58 mmol/mol). By week 12, 28% and 27% of newly and previously initiated participants, respectively, achieved individualized HbA1c targets with modest average daily insulin dose increases of 9 and 5 U (0.10 and 0.06 U/kg), respectively from baseline (14 and 23 U [0.17 and 0.29 U/kg], respectively). Overall, 16% of participants experienced at least one episode of hypoglycemia. Both the incidence and frequency of hypoglycemia, but not severity, were positively associated with a higher likelihood of achieving individualized HbA1c targets (p<0.05).

CONCLUSIONS: In this prospective real-world study, most participants using basal insulin did not achieve individualized HbA1c targets set by their physicians. Participants who experienced symptomatic hypoglycemia were more likely to achieve HbA1c targets than those who did not. This article is protected by copyright. All rights reserved.

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