Predictors of treatment response in type-2 diabetes patients initiating basal-supported oral therapy with insulin glargine 100 U/mL - a sub-analysis of the Titration and OPtimisation (TOP) registry.

Aim was to identify predictors of long-term response to the initiation of basal-supported oral therapy (BOT) with insulin glargine (IGlar-100). Patients from the observational TOP registry were grouped into those who had (responders) and who had not achieved (non-responders) their HBA1c target and/or FBG ≤110 mg/dL 12 months after IGlar-100 initiation. Independent predictors of treatment response were identified by regression analysis. Data for 2,444 patients were analysed (responders: n=1,610; non-responders: n=834). Though the IGlar-100 dose increase over 12 months was larger for non-responders (+12.83 vs. +9.46 U/d; p<0.0001), the corresponding decrease in HbA1c was smaller (-0.88% vs. -1.57%). Independent predictors of response included a lower BMI (OR 0.97; 95%CI 0.95-1.00), lower FBG (OR 0.98; 95%CI 0.97-0.98) and HbA1c values at baseline (OR 0.24; 95%CI 0.18-0.31), a more lenient HbA1c target (OR 5.07; 95%CI 3.37-7.63) and bedtime administration of IGlar-100 (OR 1.55; 95%CI 1.12-2.14). In conclusion, HbA1c was the clinically most significant baseline characteristic predictive of response to BOT. This may suggest an advantage for IGlar-100 initiation prior to excessive hyperglycaemia escalation. This article is protected by copyright. All rights reserved.