{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:49:41Z","timestamp":1790174981793,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T00:00:00Z","timestamp":1445904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To use continuous glucose monitoring to examine the effects of insulin initiation with glargine, with or without glulisine, on glycaemic variability and glycaemia in a cohort of people with Type 2 diabetes receiving maximum oral hypoglycaemic agents in primary healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a <jats:italic>post hoc<\/jats:italic> analysis of continuous glucose monitoring data from 89 participants at baseline and at 24 weeks after insulin commencement. Indicators of glycaemic variability (standard deviation, J\u2010index and mean amplitude of glycaemic excursion) and glycaemia (HbA<jats:sub>1c<\/jats:sub>, mean glucose, area under the glucose\u2013time curve) were assessed. Multi\u2010level regression analysis was used to identify the predictors of change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complete glycaemic variability data were available for 78 participants. Of these participants, 41% were women, their mean (<jats:sc>sd<\/jats:sc>) age was 59.2 (10.4) years, the median (interquartile range) diabetes duration was 10.4 (6.5, 13.3) years and the median (interquartile range) baseline HbA<jats:sub>1c<\/jats:sub> was 82.5 (71.6, 96.7) mmol\/mol [9.7 (8.7, 11.0)%]. At baseline, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> correlated negatively with standard deviation (<jats:italic>r<\/jats:italic> = \u22120.30) and mean amplitude of glycaemic excursion (<jats:italic>r<\/jats:italic> = \u22120.26), but not with J\u2010index; HbA<jats:sub>1c<\/jats:sub> correlated with J\u2010index (<jats:italic>r<\/jats:italic> = 0.61) but not with mean amplitude of glycaemic excursion and standard deviation. After insulin initiation the mean (<jats:sc>sd<\/jats:sc>) glucose level decreased [from 12.0 (3.0) to 8.5 (1.6) mmol\/l; <jats:italic>P<\/jats:italic> &lt; 0.001], as did the median (interquartile range) J\u2010index [from 66.9 (47.7, 95.1) to 36.9 (27.6, 49.8) mmol\/l; <jats:italic>P<\/jats:italic> &lt; 0.001]. Baseline HbA<jats:sub>1c<\/jats:sub> correlated with a greater J\u2010index reduction (<jats:italic>r<\/jats:italic> = \u22120.45; <jats:italic>P<\/jats:italic> &lt; 0.001). The mean amplitude of glycaemic excursion and standard deviation values were unchanged. The baseline temporal profile, showing elevated postprandial morning glucose levels, was unchanged after insulin initiation, despite an overall reduction in glycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insulin initiation reduced hyperglycaemia but did not alter glycaemic variability in adults with Type 2 diabetes receiving maximum oral hypoglycaemic agents. The most significant postprandial excursions were seen in the morning, which identifies prebreakfast as the most effective target for short\u2010acting insulin therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12979","type":"journal-article","created":{"date-parts":[[2015,10,5]],"date-time":"2015-10-05T01:54:46Z","timestamp":1444010086000},"page":"803-811","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of insulin initiation on glycaemic variability and glucose profiles in a primary healthcare Type 2 diabetes cohort: analysis of continuous glucose monitoring data from the <scp>INITIATION<\/scp> study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-3482","authenticated-orcid":false,"given":"J.","family":"Manski\u2010Nankervis","sequence":"first","affiliation":[{"name":"Department of General Practice University of Melbourne Carlton, Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Yates","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne Melbourne Vic. Australia"},{"name":"Department of Diabetes and Endocrinology Royal Melbourne Hospital Parkville Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Blackberry","sequence":"additional","affiliation":[{"name":"Department of General Practice University of Melbourne Carlton, Vic. Australia"},{"name":"La Trobe University Wodonga Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Furler","sequence":"additional","affiliation":[{"name":"Department of General Practice University of Melbourne Carlton, Vic. 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