Different Injection Frequencies of Basal Insulins in Type 2 Diabetes Patients under Real-Life Conditions: A Retrospective Database Analysis. (September 2013)

• Record Type: Journal Article
• Authors: Rathmann, Wolfgang; Dippel, Franz W.; Kostev, Karel
• Is Part Of: Journal of diabetes science and technology. Volume 7:Number 5(2013)
• Page Start: 1354
• Page End: 1358
• Publication Date: 2013-09
• Subjects: injection frequency -- insulin therapy -- pharmacoepidemiology -- primary care; Diabetes -- Periodicals; Medical technology -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1177/193229681300700527
• Languages: English
• ISSNs: 1932-2968

Abstract

Aims: Little is known about routine use of basal insulins [glargine, detemir, neutral protamine Hagedorn (NPH)] in primary care patients with type 2 diabetes. The aim was to compare injection frequencies of basal insulins in type 2 diabetes in primary care practices, both for basal-supported oral therapy (BOT) and basal-bolus treatment [intensified conventional therapy (ICT)] regimens. Methods: Primary care data from 4211 glargine (BOT/ICT, 2247/1964), 1290 detemir (490/800), and 3876 NPH (1331/2425) insulin users were retrospectively analyzed (Disease Analyzer database, May 2009-April 2012). Logistic regression (>1 daily injection) and propensity scores were used to adjust for various confounders (age, sex, type of physician, dosage, body mass index, glycosylated hemoglobin). Results: Overall, >1 daily injections were observed in 7.5% of glargine users (BOT, 6.2%; ICT, 9.0%), which was lower than for detemir (overall, 25.4%; BOT, 22.0%; ICT, 27.4%) and NPH (25.4%; BOT, 23.9%; ICT, 27.2%) insulin (all p < .001). The adjusted odds of having >1 injection was lower for glargine compared with detemir (odds ratio, 0.26; 95% CI 0.22–0.32) and NPH-insulin (0.20; 0.17–0.23). Similar results were found for BOT or ICT and after propensity score matching. Conclusions: Glargine is associated with significantly lower injection frequencies than other basal insulins. These findings might impact patient-reported outcomes, quality of life, treatment satisfaction, and economic aspects of diabetes treatment.