PMID- 31976334 OWN - NLM STAT- MEDLINE DCOM- 20200622 LR - 20221207 IS - 2314-6753 (Electronic) IS - 2314-6745 (Print) VI - 2019 DP - 2019 TI - Insulin Glargine U100 Utilization in Patients with Type 2 Diabetes in an Italian Real-World Setting: A Retrospective Study. PG - 3174654 LID - 10.1155/2019/3174654 [doi] LID - 3174654 AB - BACKGROUND: This study is aimed at estimating the proportion of type 2 diabetes mellitus (T2DM) patients treated with basal insulin (insulin glargine U100) and at evaluating daily insulin dose, treatment pattern, and adherence to treatment of these patients. METHODS: Data from administrative and laboratory databases of 3 Italian Local Health Units were retrospectively collected and analyzed. All patients with a diagnosis of T2DM between 01/01/2012 and 31/12/2012 were considered, and those with at least a prescription of insulin glargine between 01/01/2013 and 31/12/2014 were included and followed up for one year. For each patient, we evaluated HbA1c levels both at baseline and during the follow-up period and the daily average dose of insulin. Medication adherence was defined by using medication possession ratio (MPR) and reported as proportion of patients with MPR >/= 80%. RESULTS: 7,422 T2DM patients were available for the study. According to the antidiabetic medication prescribed, patients were categorized into four groups: insulin glargine only, insulin glargine plus oral glucose-lowering drugs, insulin glargine plus rapid-acting insulin, and insulin glargine plus DPP-4 inhibitors. Median daily dose of insulin among insulin glargine only patients was higher than in other groups (35 IU vs. 20 IU, p < 0.05), and a higher percentage of them achieved a target HbA1c value of less than 7.0% (53.8% vs. 30%, p < 0.001). Adherence to insulin treatment was lowest (41%) in the insulin glargine only group compared to other groups (ranging from 58.4% to 64.4%), p < 0.001. CONCLUSIONS: A large proportion of T2DM patients treated with insulin fail in achieving the glycemic target of HbA1c level < 7%, irrespective of treatment regimen; however, basal insulin only is associated with lower therapeutic unsuccess. Adherence to antidiabetes medications is also suboptimal in these patients and should be addressed to improve long-term outcomes of reducing and preventing microvascular and macrovascular complications. CI - Copyright (c) 2019 Luca Degli Esposti et al. FAU - Esposti, Luca Degli AU - Esposti LD AD - Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy. FAU - Perrone, Valentina AU - Perrone V AUID- ORCID: 0000-0001-5018-490X AD - Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy. FAU - Saragoni, Stefania AU - Saragoni S AD - Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy. FAU - Blini, Valerio AU - Blini V AD - Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy. FAU - Buda, Stefano AU - Buda S AD - Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy. FAU - D'avella, Rosella AU - D'avella R AD - Complex Operation Unit-Pharmaceutical Department of Arezzo-Toscana Sud Est Local Health Unit, Arezzo, Italy. FAU - Gasperini, Gina AU - Gasperini G AD - Complex Operation Unit of Hospital Pharmacy for Hospital of Siena-Territory Continuity of Care, Toscana Sud Est Local Health Unit, Siena, Italy. FAU - Lena, Fabio AU - Lena F AD - Local Health Unit-Pharmaceutical Department of Grosseto, Toscana Sud Est Local Health Unit, Grosseto, Italy. FAU - Fanelli, Francesca AU - Fanelli F AD - Sanofi S.p.A, Italy. FAU - Gazzi, Luca AU - Gazzi L AD - Sanofi S.p.A, Italy. FAU - Giorgino, Francesco AU - Giorgino F AUID- ORCID: 0000-0001-7372-2678 AD - Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy. LA - eng PT - Journal Article DEP - 20191230 PL - England TA - J Diabetes Res JT - Journal of diabetes research JID - 101605237 RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (hemoglobin A1c protein, human) RN - 2ZM8CX04RZ (Insulin Glargine) SB - IM MH - Aged MH - Aged, 80 and over MH - Diabetes Mellitus, Type 2/blood/*drug therapy MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Insulin Glargine/*therapeutic use MH - Male MH - Medication Adherence MH - Middle Aged MH - Retrospective Studies PMC - PMC6955113 COIS- FF and LG are employees of Sanofi S.p.A., Italy. FG was a consultant and author for AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp and Dohme, Roche Diabetes Care, and Takeda. He received research support from and was an author and consultant for Eli Lilly, LifeScan, Sanofi, and Takeda. Other authors declare that they have no conflicts of interest in the research. LDE, VP, SS, VB, and SB are employees of Clicon S.r.l. Clicon S.r.l. is an independent company. Clicon S.r.l. and Sanofi S.p.A, each one on their own behalf, are independent contractors and their agreement cannot be interpreted in order to (i) give a party the power to govern and control the daily activities of the other party; (ii) consider parties as shareholders, members of a joint venture, client and agent, employer and employee, co-owners, or members of any other joint activities; and (iii) allow any party the right to create or assume duty on behalf of the other party. EDAT- 2020/01/25 06:00 MHDA- 2020/06/23 06:00 PMCR- 2019/12/31 CRDT- 2020/01/25 06:00 PHST- 2019/04/11 00:00 [received] PHST- 2019/12/07 00:00 [accepted] PHST- 2020/01/25 06:00 [entrez] PHST- 2020/01/25 06:00 [pubmed] PHST- 2020/06/23 06:00 [medline] PHST- 2019/12/31 00:00 [pmc-release] AID - 10.1155/2019/3174654 [doi] PST - epublish SO - J Diabetes Res. 2019 Dec 30;2019:3174654. doi: 10.1155/2019/3174654. eCollection 2019.