Quality of Life and Insulin Therapy in Type 2 Diabetes Mellitus |
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| Institution: | 1. Internal Medicine and Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;2. Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt;3. Rheumatology and Rehabilitation Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;4. Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;5. Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt;1. APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Nutrition Paris, France;2. Université de Paris, Paris, France;3. Echosens, Paris, France;4. APHP. Centre-Université de Paris, Hôpital Européen Georges-Pompidou, Service de Chirurgie Digestive, Paris, France;5. Département d’Anatomie Pathologie, APHP, Hôpital Bichat-Beaujon, Paris, France;6. Service d''anatomopathologie, Hôpital Ambroise Paré, Boulogne-Billancourt, France;7. Service d''hépato-gastroentérologie, Hôpital Ambroise Paré, Boulogne-Billancourt, France;8. Service de Chirurgie Digestive, Hôpital Saint Joseph, Paris, France;1. Departments of Medicine, Biochemistry and Molecular Biology, and Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA;1. Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital APHP and EA 3412, CRNH-IdF, Paris 13 University, 93017 Bobigny, France;2. Lilly Diabetes, Eli Lilly & Company, 92521 Neuilly-sur-Seine, France;3. Eli Lilly Italia, Sesto Fiorentino, 50019 Florence, Italy;4. U.O. Diabetologia e Malattie Metaboliche, Multimedica IRCCS Sesto San Giovanni, 20099 Milan, Italy;1. CORE—Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy;2. Laboratory of Clinical Epidemiology of Diabetes and Chronic Diseases, Fondazione Mario Negri Sud, S. Maria Imbaro (CH), Italy;3. Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA;4. S.S.D. Diabetologia, Niguarda Ca'' Granda Hospital, Milan, Italy;5. NovoNordisk SpA, Rome, Rome, Italy;6. Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy;7. NovoNordisk A/S, Bagsvaerd, Denmark;8. Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy;1. Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt;2. Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt;3. Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt;4. Department of Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt |
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| Abstract: | Background: A frequently cited barrier to insulin use in type 2 diabetes mellitus (DM) is concern about the adverse effects on quality of life. Results of studies in this area have been mixed, with insulin use showing decreased, enhanced, or no impact on quality of life.Objective: The purpose of this paper is to discuss the state of the science regarding the effects of insulin on quality of life and to present strategies providers can implement in their clinical practices to decrease barriers to insulin use among patients with type 2 DM.Methods: An English-language MEDLINE search of the current literature using the terms insulin and quality of life was conducted for this article.Results: Although patient-identified concerns regarding insulin use represent some aspects of quality of life, study results have been mixed. However, 2 large studies examining the use of insulin glargine and its effects on quality of life found that glargine was associated with significantly greater improvements in quality of life when added to oral antidiabetic agents (OADs) than was the use of OADs alone. Another study examined the effects of intensive multi- therapy (monthly visits, self-management diabetes education, and medication adjustments) on quality of life among patients with type 2 DM and found that quality-of-life scores improved among patients who initiated insulin therapy during the trial. The effects of insulin delivery systems on quality of life have also been assessed. In these studies, patients preferred insulin pens over vials and syringes and inhaled over injected insulin. Health care providers can facilitate acceptance of insulin by employing strategies to help patients overcome psychological barriers to insulin therapy.Conclusions: Although patient concerns about the effects of insulin use are legitimate, insulin therapy is often needed to achieve treatment targets. Providers can reduce the impact on quality of life by addressing barriers, helping patients improve metabolic control, and providing ongoing information and support. |
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