• Sirajudeen Shaik Alavudeen, Sultan M Alshahrani, Easwaran Vigneshwaran, Noohu Abdulla Khan, Javid I Mir, and Abubakr T M Hussein.
• Department of Clinical Pharmacy, King Khalid University, Abha, Kingdom of Saudi Arabia.
• Int. J. Clin. Pract. 2021 Mar 1; 75 (3): e13802.

ObjectivesThe safety and efficacy of treatment approaches in patients with type 2 diabetes mellitus (T2DM) after the failure of two oral hypoglycemic agents (OHAs) was studied.MethodsA combination of the ambispective study was conducted between June 2013 to June 2014 at the Asir Diabetes Center, Abha, Kingdom of Saudi Arabia (KSA). Patients with poorly controlled T2DM who were administered two OHAs for at least 6 months and had HbA1c levels greater than 7.0% were included. Subjects were treated with three OHAs (Group I), biphasic insulin and metformin (Group II), two existing OHAs and basal insulin (Group III), and insulin monotherapy (Group IV). Relevant data were collected at baseline at the interval of 3 months for one year.ResultsAmongst 255 patients enrolled, 20.8, 29.8, 32.5, and 16.8% were in Groups I, II, III, and IV, respectively. The mean (Glycated hemoglobin) HbA1c levels were decreased significantly in the groups where insulin was an add-on therapy with the OHAs. Acceptable level of HbA1C (7 %) was significantly higher amongst patients in groups II and III, whereas hypoglycemic events were higher in Group IV.ConclusionInsulin as add-on therapy with OHAs is an option for the management of T2DM where glycemic control is insufficient with two OHAs.© 2020 John Wiley & Sons Ltd.

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