naa a22 4500 51077959X CHVBK 20180411083242.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s11892-013-0366-z doi (NATIONALLICENCE)springer-10.1007/s11892-013-0366-z Insulin Use Early in the Course of Type 2 Diabetes Mellitus: The ORIGIN Trial [Elektronische Daten] [Markolf Hanefeld, Peter Bramlage] There has been a recent shift from a uniform treatment targeting HbA1c to a patient centered approach due to disappointing results of intensified glucose control in mega-trials such as VADT, ADVANCE, and ACCORD. In addition, morbidity and mortality has been substantially reduced since the UKPDS leading to an overestimation of the absolute risk for cardiovascular complications in randomized controlled trials. With substantial progress in prevention of cardiovascular complications, patients with type 2 diabetes now survive long enough to face diabetes-related complications and cancer risk. This requires rethinking of antidiabetic treatment strategies as exemplified by a recent consensus statement of the EASD and ADA, calling for a more patient centered treatment. Within this context the value of early insulin initiation was reinforced, the clinical utility of which has been demonstrated in the recent ORIGIN trial. ORIGIN demonstrated neutral results for the primary endpoint, but reduced microangiopathy in patients with an HbA1c value of ≥6.4% with basal insulin glargine. After 5years of follow-up 77% of the patients in the glargine arm and 66% with standard care remained at an HbA1c <7%. An ongoing long-term follow-up (ORIGINALE) will clarify whether this also translates into a reduction of macrovascular events and mortality. The Author(s), 2013 Type 2 diabetes nationallicence Insulin nationallicence Consensus nationallicence Patient centered nationallicence ORIGIN trial nationallicence Hanefeld Markolf GWT-TUD mbH, Study Center Professor Hanefeld, Fiedlerstr. 34, 01307, Dresden, Germany aut Bramlage Peter Institute for Pharmacology and Preventive Medicine, Menzelstrasse 21, 15831, Mahlow, Germany aut Current Diabetes Reports Current Science Inc. 13/3(2013-06-01), 342-349 1534-4827 13:3<342 2013 13 11892 https://doi.org/10.1007/s11892-013-0366-z text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11892-013-0366-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hanefeld Markolf GWT-TUD mbH, Study Center Professor Hanefeld, Fiedlerstr. 34, 01307, Dresden, Germany aut NATIONALLICENCE 700 1- Bramlage Peter Institute for Pharmacology and Preventive Medicine, Menzelstrasse 21, 15831, Mahlow, Germany aut NATIONALLICENCE 773 0- Current Diabetes Reports Current Science Inc 13/3(2013-06-01), 342-349 1534-4827 13:3<342 2013 13 11892 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer