PMID- 32651837
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 8
DP  - 2020 Aug
TI  - Persistence with Basal Insulin and Frequency of Hypoglycemia Requiring 
      Hospitalization in Patients with Type 2 Diabetes.
PG  - 1861-1872
LID - 10.1007/s13300-020-00874-2 [doi]
AB  - INTRODUCTION: A second-generation basal insulin analogue insulin glargine 
      300 U/mL (Gla-300) has been marketed in France since June 2016. This real-world 
      study was designed to assess persistence with Gla-300 and the prevalence of 
      related hypoglycemia requiring hospitalization as compared to first-generation 
      basal insulins, in patients with type 2 diabetes mellitus (T2DM). METHODS: A 
      retrospective study was conducted using data in the large French comprehensive 
      national healthcare system claims databases. Patients with T2DM newly treated 
      with insulin in 2016 and 2017 (2-year period) were included. Three basal insulins 
      [Gla-300, glargine 100 U/mL (Gla-100; both branded and biosimilar) and insulin 
      detemir (IDet)] were compared for (1) persistence until treatment discontinuation 
      using adjusted Cox models and (2) hypoglycemia requiring hospitalization over the 
      period of insulin exposure. RESULTS: During the 2-year study period, in France, 
      181,263 patients initiated basal insulin therapy (in a basal scheme or a more 
      complex insulin scheme), of whom 74% initiated Gla-100, 14.2% initiated IDet and 
      11.8% initiated Gla-300. Patient characteristics varied according to the insulin 
      regimen in terms of age, gender, social coverage, insulin scheme, and Charlson 
      Comorbidity Index. Overall, 72% of patients were still treated with any basal 
      insulin after 1 year (75% in basal scheme). In all insulin treatment regimens, 
      patients were less likely to discontinue Gla-300 as compared to Gla-100 [adjusted 
      odds ratio (OR) 0.39, 95% confidence interval (CI) 0.37-0.41], with similar 
      results when only the basal scheme was considered (adjusted OR 0.38, 95% CI 
      0.35-0.40). Persistence with IDet was similar to that with Gla-100. Patients 
      treated with Gla-100 had higher crude hospitalization rates for hypoglycemia than 
      those receiving Gla-300 (1.4 for 100 patients-years; OR 0.67, 95% CI 0.55-0.81); 
      however, this difference was not statistically significant after adjustment for 
      patient characteristics. Emergency Room (ER) visits were less frequent in 
      patients treated with Gla-300 versus Gla-100 with or without adjustment for 
      patient characteristics (p < 0.0001). CONCLUSION: Real-world persistence for 
      basal insulin therapy in patients with T2DM was significantly better in those on 
      Gla-300 compared with those on Gla-100 and IDet. A trend to a lower frequency of 
      hospitalization for hypoglycemia and ER visits, whatever the cause, was also 
      observed in patients on Gla-300.
FAU - Roussel, Ronan
AU  - Roussel R
AD  - Endocrinology Department, Hopital Bichat Claude Bernard, Centre Hospitalier 
      Universitaire (CHU)-Paris, Paris, France.
FAU - Detournay, Bruno
AU  - Detournay B
AUID- ORCID: 0000-0001-7843-4608
AD  - CEMKA-EVAL, Bourg-La-Reine, France. Bruno.Detournay@cemka.fr.
FAU - Boultif, Zahra
AU  - Boultif Z
AD  - Sanofi, Gentilly, France.
FAU - Bahloul, Amar
AU  - Bahloul A
AD  - Sanofi, Gentilly, France.
FAU - Teissier, Clement
AU  - Teissier C
AD  - CEMKA-EVAL, Bourg-La-Reine, France.
FAU - Charbonnel, Bernard
AU  - Charbonnel B
AD  - Endocrinology Department, Nantes University Hospital Hotel-Dieu, Nantes, France.
LA  - eng
PT  - Journal Article
DEP - 20200710
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7376764
OTO - NOTNLM
OT  - Basal insulin
OT  - Claims analyses
OT  - Hypoglycemia
OT  - Medication persistence
OT  - Type 2 diabetes mellitus
EDAT- 2020/07/12 06:00
MHDA- 2020/07/12 06:01
PMCR- 2020/07/10
CRDT- 2020/07/12 06:00
PHST- 2020/05/17 00:00 [received]
PHST- 2020/07/12 06:00 [pubmed]
PHST- 2020/07/12 06:01 [medline]
PHST- 2020/07/12 06:00 [entrez]
PHST- 2020/07/10 00:00 [pmc-release]
AID - 10.1007/s13300-020-00874-2 [pii]
AID - 874 [pii]
AID - 10.1007/s13300-020-00874-2 [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Aug;11(8):1861-1872. doi: 10.1007/s13300-020-00874-2. Epub 
      2020 Jul 10.