Basal insulin (BI) treatment is usually delayed in patients with T2DM despite its proven efficacy. We report the largest 6-month prospective study in China to evaluate the safety and glucose control after introduction of BI in real-life in the 2nd or 3rd tier hospitals. Inadequately controlled with OADs (A1C ≥7%), adults (N=18,995) with T2DM were enrolled at 209 hospitals (different regions of China) and had 3 visits (baseline, 3 and 6 months). Type of BI used was at the physician’s discretion. Mean age was 55.4±10.4 years, with 6.4±5.3 diabetes duration (~50% men). Long-acting BI was most commonly used (82.5%-visit 1, 69.9%-visit 2, 64.2%- visit 3; Figure), with intermediate-acting NPH insulin used by <18% at all visits. Long-acting BI-glargine was used by 70% at visit 1, 59% at visit 2, and 54% at visit 3 of patients, whereas detemir was used in <13% at each visit. >70% of glargine and detemir users continued to use the same insulin throughout the study. 40% of patients did not change their insulin dose at all in the first 3 months.

There was a significant improvement in A1c values at 3 months, which was maintained at 6 months (Figure). Target FBG (<7.0 mmol/L) and A1C (<7%) were achieved in 43% and 41% of patients, respectively. Hypoglycemia was higher with no weight gain for long-acting BI. We conclude that BI initiation in real-life improves glucose control at 3 and 6 months in the ORBIT study.