A comparison of intermediate and long-acting insulins in people with type 2 diabetes starting insulin: an observational database study

Summary Aims: Insulin is normally added to oral glucose‐lowering drugs in people with type 2 diabetes when glycaemic control becomes suboptimal. We evaluated outcomes in people starting insulin therapy with neutral protamine Hagedorn (NPH), detemir, glargine or premixed insulins. Methods: Insulin‐naïve people with type 2 diabetes (n = 8009), ≥ 35 years old, HbA1c≥ 6.5% and begun on NPH (n = 1463), detemir (n = 357), glargine (n = 2197) or premix (n = 3992), were identified from a UK database of primary care records (The Health Improvement Network). Unadjusted and multivariate‐adjusted analyses were conducted, with persistence of insulin therapy assessed by survival analysis. Results: In the study population (n = 4337), baseline HbA1c was 9.5 ± 1.6%, falling to 8.4 ± 1.5% over 12 months (change −1.1 ± 1.8%, p