Abstract
We have reported that, among treatment groups, glycemic control is poorest in those with Type 2 diabetes mellitus (T2DM) treated with insulin combined with an oral hypoglycemic agent (OHA). We analyzed data from 55 institutes using CoDiC®, an electronic diabetes data collection and management system, to determine the actual status of subjects treated with combination therapy. Of 43,574 T2DM cases registered in 2008, 4,684 were treated with combination therapy. Compared to T2DM subjects treated with either diet and/or OHA, onset age was younger and diabetes duration longer in those treated using combination therapy and their body mass index (BMI), HbA1c, and postprandial glycemia highest. The most commonly prescribed insulin was premixed and OHA was metformin. To determine the relationship between clinical aspects and glycemic control in these subjects, we analyzed factors affecting glycemic control stratified by HbA1c level. In those with HbA1c ≥8.0%, age and onset age were markedly lower and BMI, systolic blood pressure, and LDL-cholesterol higher than in those with HbA1c <8.0%. In Japan, T2DM subjects treated with combination therapy had the poorest glycemic control, particularly those who were younger, had earlier disease onset, and were obese.
