The predictive role of HbA₁(c) and previous medications in initiation of insulin treatment.

Introduction: Subjects (n = 46) with type 2 diabetes who responded inadequately to two and three oral medications (HbA₁(C) > 8.0%) were consecutively recruited for treatment with premixed insulin 30/70 two times a day in order to investigate whether previous oral therapies may predict insulin requirements.

Material And Methods: In this prospective study, men and women were eligible to participate if they were aged between 30 and 65 years, had had a diagnosis of type 2 diabetes mellitus for at least 12 months, were insulin-naive and had been treated unsuccessfully with either two or three oral antidiabetic drugs for a minimum of three months. Clinical and laboratory findings were analyzed at one year follow-up.

Results: The average required insulin doses were significantly higher in patients in whom previous triple oral medication had failed than in patients in whom two oral drugs had failed.

Conclusion: Evaluation of the previous number of oral antidiabetic drugs and HbA₁(C) values may help us predict the insulin requirement when oral drugs have failed.