PMID- 24831915
OWN - NLM
STAT- MEDLINE
DCOM- 20160323
LR  - 20221207
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 31
IP  - 5
DP  - 2014 May
TI  - Much ado about nothing? A real-world study of patients with type 2 diabetes 
      switching Basal insulin analogs.
PG  - 539-60
LID - 10.1007/s12325-014-0120-1 [doi]
AB  - INTRODUCTION: Type-2 diabetes mellitus (T2DM) is a progressive disease, and many 
      patients eventually require insulin therapy. This study examined real-world 
      outcomes of switching basal insulin analogs among patients with T2DM. METHODS: 
      Using two large United States administrative claims databases (IMPACT((R)) and 
      Humana((R))), this longitudinal retrospective study examined two cohorts of adult 
      patients with T2DM. Previously on insulin glargine, Cohort 1 either continued 
      insulin glargine (GLA-C) or switched to insulin detemir (DET-S), while Cohort 2 
      was previously on insulin detemir, and either continued insulin detemir (DET-C) 
      or switched to insulin glargine (GLA-S). One-year follow-up treatment persistence 
      and adherence, glycated hemoglobin (HbA1c), hypoglycemia events, healthcare 
      utilization and costs were assessed. Selection bias was minimized by propensity 
      score matching between treatment groups within each cohort. RESULTS: A total of 
      5,921 patients (mean age 60 years, female 50.0%, HbA1c 8.6%) were included in the 
      analysis (Cohort 1: IMPACT((R)): n = 536 DET-S matched to n = 2,668 GLA-C; 
      Humana((R)): n = 256 DET-S matched to n = 1,262 GLA-C; Cohort 2: n = 419 GLA-S 
      matched to n = 780 DET-C), with similar baseline characteristics between 
      treatment groups in each cohort. During 1-year follow-up, in Cohort 1, DET-S 
      patients, when compared with GLA-C patients, had lower treatment 
      persistence/adherence with 33-40% restarting insulin glargine, higher 
      rapid-acting insulin use, worse HbA1c outcomes, significantly higher diabetes 
      drug costs, and similar hypoglycemia rates, health care utilization and total 
      costs. However, in Cohort 2 overall opposite outcomes were observed and only 
      19.8% GLA-S patients restarted insulin detemir. CONCLUSIONS: This study showed 
      contrasting clinical and economic outcomes when patients with T2DM switched basal 
      insulin analogs, with worse outcomes observed for patients switching from insulin 
      glargine to insulin detemir and improved outcomes when switching from insulin 
      detemir to insulin glargine. Further investigation into the therapeutic 
      interchangeability of insulin glargine and insulin detemir in the real-world 
      setting is needed.
FAU - Wei, Wenhui
AU  - Wei W
AD  - Sanofi US, Inc., Mail Stop 55C-220A, 55 Corporate Drive, Bridgewater, NJ, 08807, 
      USA, Wenhui.Wei@sanofi.com.
FAU - Zhou, Steve
AU  - Zhou S
FAU - Miao, Raymond
AU  - Miao R
FAU - Pan, Chunshen
AU  - Pan C
FAU - Xie, Lin
AU  - Xie L
FAU - Baser, Onur
AU  - Baser O
FAU - Gill, Jasvinder
AU  - Gill J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140516
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 2ZM8CX04RZ (Insulin Glargine)
RN  - 4FT78T86XV (Insulin Detemir)
MH  - Adult
MH  - Aged
MH  - Costs and Cost Analysis
MH  - Databases, Factual
MH  - *Diabetes Mellitus, Type 2/diagnosis/drug therapy/economics/epidemiology
MH  - Drug Substitution/*methods
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - *Hypoglycemia/chemically induced/prevention & control
MH  - Hypoglycemic Agents/administration & dosage/adverse effects
MH  - Insulin/analogs & derivatives
MH  - *Insulin Detemir/administration & dosage/adverse effects
MH  - *Insulin Glargine/administration & dosage/adverse effects
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Retrospective Studies
MH  - United States/epidemiology
PMC - PMC4033813
EDAT- 2014/05/17 06:00
MHDA- 2016/03/24 06:00
PMCR- 2014/05/16
CRDT- 2014/05/17 06:00
PHST- 2014/03/25 00:00 [received]
PHST- 2014/05/17 06:00 [entrez]
PHST- 2014/05/17 06:00 [pubmed]
PHST- 2016/03/24 06:00 [medline]
PHST- 2014/05/16 00:00 [pmc-release]
AID - 120 [pii]
AID - 10.1007/s12325-014-0120-1 [doi]
PST - ppublish
SO  - Adv Ther. 2014 May;31(5):539-60. doi: 10.1007/s12325-014-0120-1. Epub 2014 May 
      16.