Persistence of GLP-1 RA in combination with basal insulin among adults with type 2 diabetes in Canada. (July 2021)

• Record Type: Journal Article
• Authors: Abitbol, Alexander; Siemens, Rick; Nightingale, Natalie; Stewart, John; Toutounji, Marie-Josée; Goldenberg, Ronald
• Is Part Of: Diabetes research and clinical practice. Volume 177(2021)
• Publication Date: 2021-07
• Subjects: Persistence -- GLP-1 Receptor Agonist -- Basal Insulin -- Type 2 Diabetes -- Loose Combination; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2021.108920
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: The purpose of this study is to assess the persistence of Canadians with Type 2 diabetes mellitus (T2D) on loose-dose combination treatment (i.e., administered by separate devices) with a glucagon-like peptide 1 receptor agonist (GLP-1 RA) and basal insulin over 12 months. Methods: This study is a retrospective cohort study of T2D adults using a Canadian longitudinal prescription database over a 5-year period. Cohort 1 (n = 12, 411) is a primary cohort including only individuals inexperienced with the combination therapy at index. Cohort 2 (n = 13, 498) is an exploratory cohort and includes everyone regardless of previous experience on the loose-dose combination therapy. The primary endpoint is the proportion of individuals persistent and average days persistent to the loose-dose combination therapy at 12 months in Canada. Results: In Cohort 1, overall persistence was 47% in the 12-month period post-index. Persistence is similar when including all inexperienced and subsequent loose-dose combination experiences in Cohort 2 (45%). Conclusions: Canadian T2D adults taking a loose-dose combination therapy of a GLP-1 RA and basal insulin had overall low persistence and lower than reports from previous studies of GLP-1 RA or basal insulin alone. Improving persistence to combination therapy with GLP-1 RA plus basal insulin is an important issue to explore in clinical practice.