Real-World Insulin Treatment Persistence among Patients with Type 2 Diabetes |
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| Institution: | 1. Sanofi U.S., Inc, Bridgewater, NewJersey;2. PRO Unlimited, Boca Raton, Florida;3. STATinMED Research, Inc, Ann Arbor, Michigan;4. University of Michigan, Ann Arbor, Michigan.;1. Department of Medicine, University of California San Francisco, San Francisco, California;2. Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom;3. Department of Laboratory Medicine, University of California San Francisco, San Franciscoe, California.;1. Department of Clinical Sciences, Lund University, Lund, Sweden;2. North-Western State Medical University named after I.I. Mechnikov, Endocrinology Department named after academician V.G. Baranov, St. Petersburg, Russian Federation;3. Diabetes Division Clinical Development Department, Sanofi, Paris, France;4. Diabetes Medical Operation Department, Sanofi, Chilly Mazarin, France;5. Biostatistics and Programming, Sanofi NJ, USA;6. LMC Diabetes & Endocrinology, Toronto, Canada;1. Department of Clinical and Experimental Medicine, Section of Endocrinology, Research Center of Excellence AmbiSEN;2. Department of Clinical and Experimental Medicine, Section of Gynecology, University of Pisa, Pisa, Italy. |
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| Abstract: | ObjectiveTo evaluate real-world treatment persistence among patients with type 2 diabetes mellitus (T2DM) initiating treatment with insulin.MethodsPatient-level data were pooled from 3 previously published observational retrospective studies evaluating patients with T2DM who were previously on oral antidiabetic drugs (OADs) and initiated with a basal analog insulin (insulin glargine or insulin detemir). Treatment persistence was defined as remaining on the study drug during the 1-year follow-up period without discontinuation or switching after study drug initiation. Analyses were conducted to identify baseline factors associated with persistence with insulin therapy and to estimate the association between insulin treatment persistence and patients’ clinical and economic outcomes during the follow-up period.ResultsA total of 4,804 patients with T2DM (insulin glargine: n = 4,172, insulin detemir: n = 632) were included. The average insulin persistence rate over the 1-year follow-up period was 65.0%. A significantly higher persistence rate was associated with older age, initiation with insulin glargine using either disposable pens or vial-and-syringe, and with baseline exenatide or sitagliptin use. Higher insulin treatment persistence was also associated with lower hemoglobin A1c (A1C) at follow-up, a greater reduction in A1C from baseline, and lower health care utilization.ConclusionIn real-world settings, treatment persistence among patients with T2DM initiating basal insulin is influenced by the type of insulin and patient factors. Greater insulin treatment persistence is linked to improved clinical outcomes and reduced health care utilization. (Endocr Pract. 2014;20:52-61) |
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