PMID- 24086105
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131002
LR  - 20211021
IS  - 1177-889X (Print)
IS  - 1177-889X (Electronic)
IS  - 1177-889X (Linking)
VI  - 7
DP  - 2013
TI  - Real world outcomes of adding rapid-acting insulin versus switching to analog 
      premix insulin among US patients with type 2 diabetes treated with insulin 
      glargine.
PG  - 951-60
LID - 10.2147/PPA.S49287 [doi]
AB  - INTRODUCTION: Patients with type 2 diabetes mellitus (T2DM) often require 
      intensification of basal insulin therapy. This retrospective, observational study 
      compared real-world outcomes in US patients with T2DM treated with insulin 
      glargine who added a rapid-acting insulin (RAI) (basal-bolus approach) with those 
      who switched to premixed insulin (PMX). METHODS: The national US IMPACT(R) database 
      was used to identify data from adult patients (>/=18 years of age) with T2DM who 
      added bolus RAI to insulin glargine (GLA + RAI) or who switched from GLA to PMX 
      between 2001 and 2009. A stringent 1:1 propensity score-matching method was used 
      to address the selection bias by matching GLA + RAI patients and PMX patients. 
      Clinical and economic outcomes were determined for 1 year after the initial 
      pharmacy claim for RAI or for PMX. Outcomes included treatment persistence and 
      adherence, average insulin doses, glycated hemoglobin (A1C) levels, the 
      prevalence and incidence of hypoglycemia, and health care costs/utilization. 
      Analysis was carried out using an intent-to-treat approach. RESULTS: The study 
      included data from 746 propensity-matched patients (n = 373 in each cohort). 
      Treatment persistence and adherence were higher in the GLA + RAI cohort. There 
      was no significant difference in A1C reduction from baseline and the number of 
      patients achieving target A1C levels of <7% in each cohort. The incidence of 
      hypoglycemic events was also similar in both groups. However, during follow-up, 
      many patients (48.8%) who initially switched from insulin glargine to PMX crossed 
      back over to use GLA and/or RAI as part of their regimen. Health care costs and 
      utilization levels were not significantly different. CONCLUSION: Clinical and 
      economic outcomes were similar in T2DM patients who added RAI to GLA and in those 
      who switched to PMX, but a basal-bolus strategy appears to be associated with 
      better treatment persistence and adherence.
FAU - Miao, Raymond
AU  - Miao R
AD  - Sanofi US, Bridgewater, NJ, USA.
FAU - Wei, Wenhui
AU  - Wei W
FAU - Baser, Onur
AU  - Baser O
FAU - Xie, Lin
AU  - Xie L
LA  - eng
PT  - Journal Article
DEP - 20130919
PL  - New Zealand
TA  - Patient Prefer Adherence
JT  - Patient preference and adherence
JID - 101475748
PMC - PMC3786817
OTO - NOTNLM
OT  - clinical outcomes
OT  - insulin glargine
OT  - premixed insulin
OT  - rapid-acting insulin
OT  - treatment persistence
OT  - type 2 diabetes mellitus
EDAT- 2013/10/03 06:00
MHDA- 2013/10/03 06:01
PMCR- 2013/09/19
CRDT- 2013/10/03 06:00
PHST- 2013/10/03 06:00 [entrez]
PHST- 2013/10/03 06:00 [pubmed]
PHST- 2013/10/03 06:01 [medline]
PHST- 2013/09/19 00:00 [pmc-release]
AID - ppa-7-951 [pii]
AID - 10.2147/PPA.S49287 [doi]
PST - epublish
SO  - Patient Prefer Adherence. 2013 Sep 19;7:951-60. doi: 10.2147/PPA.S49287. 
      eCollection 2013.