Introduction: Type 2 diabetes mellitus (T2DM) management is challenging in conflict zones, such as Iraq,
and insulin might not be readily prescribed or available to patients who need it. This study describes the
profile of Iraqi T2DM patients treated with insulin glargine-100 (Glar-100) and their response to the
treatment.
Research design and methods: This observational, multicenter registry collected data over six months on
demographic and medical history, insulin regimen, changes in glycemic parameters, and vital signs in
patients with T2DM in Iraq.
Results: Patients (N = 245) were 55.2 ± 10.2 years old, with 58.4% females. They had had diabetes for 10
years, with baseline glycated hemoglobin (HbA1c) levels of 10.3% ± 1.6% (89 mmol/mol), diabetes
complications, and co-morbidities. Almost all were on oral anti-diabetics before treatment intensification
with Glar-100. Over 50% of patients with prior insulin exposure were receiving basal plus or bolus regimens
at baseline, versus 6% of insulin-naïve patients, though some required treatment intensification. Most were
asked to self-titrate according to fasting plasma glucose (FPG), but self-titration proved challenging. Upon
Glar-100 treatment, HbA1c and FPG levels significantly decreased (P < 0.001), and 20% of patients (mostly
insulin-naïve) achieved HbA1c < 7% (53 mmol/mol). Vital signs improved, while weight changes were
modest. Most safety events were mild, and only two patients discontinued Glar-100.
Conclusion. Glar-100 safely and effectively decreased FPG and HbA1c levels, achieving HbA1c control in
some patients. Glar-100 is a promising T2DM therapeutic option in Iraq
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Published 11/06/2022
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