PMID- 25148821
OWN - NLM
STAT- MEDLINE
DCOM- 20160829
LR  - 20220408
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 21
IP  - 1
DP  - 2015 Jan
TI  - Adding Rapid-Acting Insulin or GLP-1 Receptor Agonist to Basal Insulin: Outcomes 
      in a Community Setting.
PG  - 68-76
LID - 10.4158/EP14290.OR [doi]
AB  - OBJECTIVE: To evaluate real-world outcomes in patients with type 2 diabetes 
      mellitus (T2DM) receiving basal insulin who initiate add-on therapy with a 
      rapid-acting insulin (RAI) or a glucagon-like peptide 1 (GLP-1) receptor agonist. 
      METHODS: Data were extracted retrospectively from a U. S. health claims database. 
      Adults with T2DM on basal insulin who added an RAI (basal + RAI) or GLP-1 
      receptor agonist (basal + GLP-1) were included. Propensity score matching (with a 
      1 up to 3 ratio) was used to control for differences in baseline demographics, 
      clinical characteristics, and health resource utilization. Endpoints included 
      prevalence of hypoglycemia, pancreatic events, all-cause and diabetes-related 
      resource utilization, and costs at 1-year follow-up. RESULTS: Overall, 6,718 
      matched patients were included: 5,013 basal + RAI and 1,705 basal + GLP1. 
      Patients in both groups experienced a similar proportion of any hypoglycemic 
      event (P = .4079). Hypoglycemic events leading to hospitalization were higher in 
      the basal + RAI cohort (2.7% vs. 1.8%; P = .0444). The basal + GLP-1 cohort 
      experienced fewer all-cause (13.55% vs. 18.61%; P<.0001) and diabetes-related 
      hospitalizations (11.79% vs. 15.68%; P<.0001). The basal + GLP-1 cohort had lower 
      total all-cause health care costs ($18,413 vs. $20,821; P = .0002) but similar 
      diabetes-related costs ($9,134 vs. $8,985; P<.0001) compared with the basal + RAI 
      cohort. CONCLUSIONS: Add-on therapy with a GLP-1 receptor agonist in T2DM 
      patients receiving basal insulin was associated with fewer hospitalizations and 
      lower total all-cause costs compared with add-on therapy using an RAI and could 
      be considered as an alternative to an RAI in certain patients with T2DM who do 
      not achieve effective glycemic control with basal insulin.
FAU - Dalal, Mehul R
AU  - Dalal MR
AD  - Sanofi U. S., Inc., Bridgewater, New Jersey.
FAU - Xie, Lin
AU  - Xie L
AD  - STATinMED Research, Inc., Ann Arbor, Michigan.
FAU - Baser, Onur
AU  - Baser O
AD  - STATinMED Research, Inc., Ann Arbor, Michigan University of Michigan, Ann Arbor, 
      Michigan School of Economy, Administrative and Social Sciences, MEF University, 
      Istanbul, Turkey.
FAU - DiGenio, Andres
AU  - DiGenio A
AD  - Isis Pharmaceuticals, Inc., Carlsbad, California.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Short-Acting)
SB  - IM
CIN - Endocr Pract. 2015 Jan;21(1):88-90. PMID: 25628120
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glucagon-Like Peptide-1 Receptor/*agonists
MH  - Health Care Costs
MH  - Hospitalization
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Insulin/*administration & dosage
MH  - Insulin, Short-Acting/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2014/08/26 06:00
MHDA- 2016/08/30 06:00
CRDT- 2014/08/24 06:00
PHST- 2014/08/24 06:00 [entrez]
PHST- 2014/08/26 06:00 [pubmed]
PHST- 2016/08/30 06:00 [medline]
AID - S1530-891X(20)43346-4 [pii]
AID - 10.4158/EP14290.OR [doi]
PST - ppublish
SO  - Endocr Pract. 2015 Jan;21(1):68-76. doi: 10.4158/EP14290.OR.