Glargine prescribing practices for Type 2 diabetes: is there room for improvement?

elliott‐kemp y, ahern k & ostini r (2011) Journal of Nursing and Healthcare of Chronic Illness   3 , 352–360 
 Glargine prescribing practices for Type 2 diabetes: is there room for improvement? Aim.  This study investigated Glargine prescribing practices at an outpatient clinic in a tertiary hospital. Background.  Treatment outcomes for people with Type 2 diabetes have improved with the introduction of the basal insulin Glargine. However, to achieve optimal therapeutic results in a safe fashion, this insulin must be titrated in accordance with the manufacturer’s recommendation. Method.  Medical records of patients with Type 2 diabetes who had attended an outpatient clinic between 2007–2008 were reviewed. Data collected included the age and gender of the patient, whether the patient’s insulin dose had been titrated, the Haemoglobin A1c (HbA1c) percentage on prescription of Glargine and follow‐up HbA1c results and the time elapsed between the initial and follow‐up HbA1c. Findings.  Only 14·6% of all patients had their Glargine insulin prescription adjusted according to the manufacturer’s recommendation. Despite this, prescription of Glargine insulin resulted in 43% of patients reducing their HbA1c result by at least 1%. Conclusion.  Findings suggest that Glargine insulin was a contributing factor in the reduction of the patient’s HbA1c. Relevance to clinical practice.  This study indicates that Glargine insulin is not consistently prescribed as per the manufacturer’s recommendation. Patient or clinician factors could explain why such a small percentage of patients had their Glargine prescription adjusted appropriately. Individualisation of Glargine insulin adjustment regimes, particularly in patients over the age of 75 years is vital to ensure positive patient outcomes.