(HealthDay News) — For older Medicare beneficiaries with type 2 diabetes, early insulin initiation offers clinical benefit, according to a study published in the Journal of the American Geriatrics Society.

Rituparna Bhattacharya, PhD, from West Virginia University in Morgantown, and colleagues examined the impact of the timing of insulin initiation in a cohort of Medicare beneficiaries aged at least 65 years with type 2 diabetes. 

Participants were classified according to the number of oral antidiabetes drugs that they had taken before initiation of insulin: one (early insulin initiators), two or three or more (delayed insulin initiators). Data were included for 14,669 individuals; baseline and 1-year follow-up HbA1c levels were available for 27.5% of participants.

The researchers found that for the groups with one, two and three or more oral antidiabetes drugs, the unadjusted reduction in HbA1c at follow-up was 0.9%, 0.7% and 0.5%, respectively. Early insulin initiation correlated with significantly greater decline in HbA1c (0.4%; P<.001) and increased odds of achieving HbA1c less than 8.0% (adjusted OR=1.30). 

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There were no significant differences in total costs or hypoglycemia events for early vs. delayed initiators (P=.32).

“These findings fill a crucial knowledge gap regarding the association between early insulin initiation and clinical and economic outcomes in older adults with [type 2 diabetes],” the researchers wrote.

Two authors are employees of Sanofi, and one is a shareholder; the study was funded by Sanofi.


  1. Bhattacharya R et al. J Am Geriatr Soc. 2015;63(5):893-901.