Patterns and trends in insulin initiation and intensification among patients with Type 2 diabetes mellitus in the Middle East and North Africa region. (March 2019)

• Record Type: Journal Article
• Authors: Jabbar, Abdul; Abdallah, Khalifa; Hassoun, Ahmed; Malek, Rachid; Senyucel, Cagri; Spaepen, Erik; Treuer, Tamas; Bhattacharya, Indranil
• Is Part Of: Diabetes research and clinical practice. Volume 149(2019)
• Page Start: 18
• Page End: 26
• Publication Date: 2019-03
• Subjects: Type 2 diabetes mellitus -- Middle East and North Africa -- Observational -- Insulin regimens -- Clinical inertia; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2019.01.017
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aim: Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region. Methods: 1192 patients aged ≥18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants. Results: 67.6% patients had HbA1c ≥9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on ≥2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels of <7.5%. The proportion of patients completely satisfied with their insulin treatment, and the QoL increased over the study course. Conclusion: Results support that timely initiation and early intensification of insulin therapy are necessary in the region to achieve adequate and timely glycemic control and to prevent diabetic complications.