Relationship between treatment persistence and A1C trends among patients with type 2 diabetes newly initiating basal insulin. Issue 5 (28th January 2018)

• Record Type: Journal Article
• Authors: Zhou, Fang Liz; Xie, Lin; Pan, Chunshen; Wang, Yuexi; Vaidya, Neel; Ye, Fen; Preblick, Ronald; Meneghini, Luigi
• Is Part Of: Diabetes, obesity & metabolism. Volume 20:Issue 5(2018)
• Page Start: 1298
• Page End: 1301
• Publication Date: 2018-01-28
• Subjects: basal insulin -- type 2 diabetes; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.13200
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract : This study examines the relationship between glycated haemoglobin (A1C) levels and treatment persistence with, or time to discontinuation of, basal insulin in patients with type 2 diabetes (T2D) newly initiating insulin. Claims data were extracted from the Optum Clinformatics database from January 2010 to June 2015. Adult patients with T2D initiating insulin glargine 100 U/mL (Gla‐100) or insulin detemir (DET) with ≥1 A1C measurement during 12‐month baseline and 18‐month follow‐up periods were included. Patients with a refill gap of >90 days were considered non‐persistent; otherwise, patients were considered persistent with insulin. The main outcome was A1C, measured closest to the end of each quarter during the follow‐up period. A total of 3993 of 109 934 patients met the inclusion criteria (43.0% persistent; 57.0% non‐persistent). Persistent patients were older (54.7 vs 52.7 years; P < .001), were more likely to be male (59.4% vs 54.4%; P = .002), and had significantly lower mean unadjusted A1C values at 18 months (8.26% vs 8.60%; P < .001) and quarterly. Only 43.0% of adults initiating basal insulin persisted with treatment for 18 months, with earlier discontinuation associated with higher A1C.