Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome
<h3>Introduction</h3><p dir="ltr">Many patients with Acute Coronary Syndrome (ACS) are newly diagnosed with Type 2 Diabetes Mellitus (T2DM) with very high hbA1c levels (> 10%). Early achievement of glycaemic control is of prime importance in such cases, and many guidel...
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2025
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| _version_ | 1864513533581983744 |
|---|---|
| author | Adeel Ahmad Khan (14152953) |
| author2 | Fateen Ata (12217764) Afia Aziz (18002515) Aya Janan Qassim (22504073) Ahmed Shukri (22504076) Khaled Abdallah Aboujabal (22504079) Yazan Almohtasib (22504082) Amin Jayyousi (3158868) Mohammed Bashir (5593550) Haval Surchi (20451660) |
| author2_role | author author author author author author author author author |
| author_facet | Adeel Ahmad Khan (14152953) Fateen Ata (12217764) Afia Aziz (18002515) Aya Janan Qassim (22504073) Ahmed Shukri (22504076) Khaled Abdallah Aboujabal (22504079) Yazan Almohtasib (22504082) Amin Jayyousi (3158868) Mohammed Bashir (5593550) Haval Surchi (20451660) |
| author_role | author |
| dc.creator.none.fl_str_mv | Adeel Ahmad Khan (14152953) Fateen Ata (12217764) Afia Aziz (18002515) Aya Janan Qassim (22504073) Ahmed Shukri (22504076) Khaled Abdallah Aboujabal (22504079) Yazan Almohtasib (22504082) Amin Jayyousi (3158868) Mohammed Bashir (5593550) Haval Surchi (20451660) |
| dc.date.none.fl_str_mv | 2025-06-07T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1002/edm2.70069 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Evaluating_the_Effectiveness_of_Insulin_Plus_Oral_Medications_Versus_Oral_Anti_Diabetes_Therapy_Alone_in_Patients_With_Newly_Diagnosed_Type_2_Diabetes_With_Very_High_hbA1c_and_Acute_Coronary_Syndrome/30455831 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences acute coronary syndrome newly diagnosed type 2 diabetes mellitus uncontrolled hyperglycaemia |
| dc.title.none.fl_str_mv | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Introduction</h3><p dir="ltr">Many patients with Acute Coronary Syndrome (ACS) are newly diagnosed with Type 2 Diabetes Mellitus (T2DM) with very high hbA1c levels (> 10%). Early achievement of glycaemic control is of prime importance in such cases, and many guidelines recommend starting insulin together with oral anti‐diabetic drugs (OAD) as part of discharge medications. However, large numbers of treatment‐naïve patients are hesitant to use insulin due to various factors.</p><h3>Methods</h3><p dir="ltr">In this retrospective, single‐centre, observational study, we compared the hbA1c at 1‐year follow‐up between newly diagnosed DM patients with initial hbA1c > 10% who were discharged on insulin plus OAD versus those only on OAD after admission with ACS. Pairwise comparisons between continuous and categorical study variables were performed using t‐test, Mann–Whitney test, and chi‐square. We used STATA 18 for analysis. Baseline characteristics have been described for all the patients included in the study. In the analysis of outcomes at follow‐up, only patients who had follow‐up at 1‐year were included.</p><h3>Results</h3><p dir="ltr">Of 149 patients eligible for inclusion, the majority were males (97.3%). The mean age was 47 ± 8.3 years. The baseline hbA1c at diagnosis was 11.2 (10.5–12.3) %. 38 (25.5%) Were Discharged on insulin + OADs, whereas 111 (75.5%) Were Discharged Only on OADs. There was no statistically significant difference in change in hbA1c from baseline between the two groups (Mean (SD) 4.4% ± 1.8% vs. 4% ± 1.5%, <i>p</i> = 0.07). None of the patients had any hyperglycaemic emergency, and there were no differences in recurrent admissions due to cardiac indications (<i>p</i> = 0.5).</p><h3>Conclusion</h3><p dir="ltr">An anti‐DM regimen consisting of multiple oral agents is a safe and effective alternative to insulin plus OAD and can lead to a comparable reduction in hbA1c at 1‐year in patients who are not willing to use insulin early after diagnosis of T2DM.</p><h2>Other Information</h2><p dir="ltr">Published in: Endocrinology, Diabetes & Metabolism<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/edm2.70069" target="_blank">https://dx.doi.org/10.1002/edm2.70069</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_f7adb622ad9680ceda1864a3a65e3a4b |
| identifier_str_mv | 10.1002/edm2.70069 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30455831 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary SyndromeAdeel Ahmad Khan (14152953)Fateen Ata (12217764)Afia Aziz (18002515)Aya Janan Qassim (22504073)Ahmed Shukri (22504076)Khaled Abdallah Aboujabal (22504079)Yazan Almohtasib (22504082)Amin Jayyousi (3158868)Mohammed Bashir (5593550)Haval Surchi (20451660)Biomedical and clinical sciencesCardiovascular medicine and haematologyMedical biochemistry and metabolomicsPharmacology and pharmaceutical sciencesacute coronary syndromenewly diagnosed type 2 diabetes mellitusuncontrolled hyperglycaemia<h3>Introduction</h3><p dir="ltr">Many patients with Acute Coronary Syndrome (ACS) are newly diagnosed with Type 2 Diabetes Mellitus (T2DM) with very high hbA1c levels (> 10%). Early achievement of glycaemic control is of prime importance in such cases, and many guidelines recommend starting insulin together with oral anti‐diabetic drugs (OAD) as part of discharge medications. However, large numbers of treatment‐naïve patients are hesitant to use insulin due to various factors.</p><h3>Methods</h3><p dir="ltr">In this retrospective, single‐centre, observational study, we compared the hbA1c at 1‐year follow‐up between newly diagnosed DM patients with initial hbA1c > 10% who were discharged on insulin plus OAD versus those only on OAD after admission with ACS. Pairwise comparisons between continuous and categorical study variables were performed using t‐test, Mann–Whitney test, and chi‐square. We used STATA 18 for analysis. Baseline characteristics have been described for all the patients included in the study. In the analysis of outcomes at follow‐up, only patients who had follow‐up at 1‐year were included.</p><h3>Results</h3><p dir="ltr">Of 149 patients eligible for inclusion, the majority were males (97.3%). The mean age was 47 ± 8.3 years. The baseline hbA1c at diagnosis was 11.2 (10.5–12.3) %. 38 (25.5%) Were Discharged on insulin + OADs, whereas 111 (75.5%) Were Discharged Only on OADs. There was no statistically significant difference in change in hbA1c from baseline between the two groups (Mean (SD) 4.4% ± 1.8% vs. 4% ± 1.5%, <i>p</i> = 0.07). None of the patients had any hyperglycaemic emergency, and there were no differences in recurrent admissions due to cardiac indications (<i>p</i> = 0.5).</p><h3>Conclusion</h3><p dir="ltr">An anti‐DM regimen consisting of multiple oral agents is a safe and effective alternative to insulin plus OAD and can lead to a comparable reduction in hbA1c at 1‐year in patients who are not willing to use insulin early after diagnosis of T2DM.</p><h2>Other Information</h2><p dir="ltr">Published in: Endocrinology, Diabetes & Metabolism<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/edm2.70069" target="_blank">https://dx.doi.org/10.1002/edm2.70069</a></p>2025-06-07T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/edm2.70069https://figshare.com/articles/journal_contribution/Evaluating_the_Effectiveness_of_Insulin_Plus_Oral_Medications_Versus_Oral_Anti_Diabetes_Therapy_Alone_in_Patients_With_Newly_Diagnosed_Type_2_Diabetes_With_Very_High_hbA1c_and_Acute_Coronary_Syndrome/30455831CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/304558312025-06-07T03:00:00Z |
| spellingShingle | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome Adeel Ahmad Khan (14152953) Biomedical and clinical sciences Cardiovascular medicine and haematology Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences acute coronary syndrome newly diagnosed type 2 diabetes mellitus uncontrolled hyperglycaemia |
| status_str | publishedVersion |
| title | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| title_full | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| title_fullStr | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| title_full_unstemmed | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| title_short | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| title_sort | Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti‐Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Medical biochemistry and metabolomics Pharmacology and pharmaceutical sciences acute coronary syndrome newly diagnosed type 2 diabetes mellitus uncontrolled hyperglycaemia |