OBJECTIVES: To compare the persistence with insulin Glargine (BOT = basal supported oral treatment) to those with NPH if added to oral antidiabetics. METHODS: A retrospective cohort study was conducted utilizing a representative real-life database IMS® Disease Analyzer. Patients with type 2 diabetes beginning insulin therapy with Glargine or NPH during the period 01/2003 to 08/2006 and being continuously eligible for at least 12 months after the treatment initiation were included. Follow-up was 12-57 months corresponding to the documentation length. Persistence was measured as time until switch to intensified insulin therapy (ICT). RESULTS: In total 1,242 patients were included, of whom 896 were treated with Glargine and 346 with NPH reflecting the distribution in German medical practice. The patient groups were comparable regarding age and sex and showed small differences in other characteristics. During follow-up 13.8% of patients treated with Glargine vs. 20.5% with NPH (p<0.001) were switched to ICT. The mean duration of therapy was 764.1 days on Glargine compared to 654.4 days on NPH (p<0.001). In Cox regression analyses beside the type of insulin patient’s age, diabetes duration and the treating physician group were significantly correlated with the persistence. No correlation was found for gender, insurance status, region, type of oral therapy, documentation length and year of insulin therapy initiation. Adjusting for the factors “age”, “duration of diabetes” and “physician group” the Cox regression analysis yielded a hazard ratio of 0.59 (95% CI: 0.40-0.79, p=0.0005) for switching to ICT for Glargine compared to NPH. CONCLUSIONS: This real-life data analysis showed that patients receiving BOT with Glargine are treated significantly longer compared to the NPH control group before switching to ICT. Longer treatment with BOT might be related to benefits for the patients as well as for the health care system.