scholarly journals Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Usha Sambamoorthi ◽  
Arijita Deb ◽  
Steve Zhou ◽  
Rahul Garg ◽  
Tao Fan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Real World ◽  
Basal Insulin ◽  
Acting Insulin ◽  
Insulin Use ◽  
Out Of Pocket Costs

We examined the real-world utilization and persistence of rapid acting insulin (RAI) in elderly patients with type 2 diabetes who added RAI to their drug (OAD) regimen. Insulin-naïve patients aged ≥65 years, with ≥1 OAD prescription during the baseline period, who were continuously enrolled in the US Humana Medicare Advantage insurance plan for 18 months and initiated RAI were included. Among patients with ≥2 RAI prescriptions (RAIp), persistence during the 12-month follow-up was assessed. Multivariate logistic regression analyses identified factors affecting RAI use and persistence. Of 3734 patients adding RAI to their OAD regimen, 2334 (62.5%) had a RAIp during follow-up. Factors associated with RAIp included using ≤2 OADs; cognitive impairment, basal insulin use during follow-up; and higher RAI out-of-pocket costs ($36 to <$56 versus$0 to$6.30). Patients were less likely to persist with RAI when on ≤2 OADs versus ≥3 OADs and when having higher RAI out-of-pocket costs ($36 to <$56 versus$0 to$6.30) and more likely to persist when they had cognitive impairment and basal insulin use during follow-up. Real-world persistence of RAI in insulin-naïve elderly patients with type 2 diabetes was very poor when RAI was added to an OAD regimen.

scholarly journals Real World Tolerability And Effectiveness of Exenatide Once-Weekly Compared To Basal Insulin Among Elderly Patients with Type 2 Diabetes (T2D)

2016 ◽  
Vol 19 (7) ◽  
pp. A668
Author(s):  
JD Seeger ◽  
AM Loughlin ◽  
Q Qiao ◽  
AP Nunes ◽  
S Ezzy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Elderly Patients ◽  
Real World ◽  
Basal Insulin

scholarly journals Comparative vascular safety of basal long-acting insulin analogue versus intermediate-acting human insulin in real-world patients with type 2 diabetes: a nationwide population-based cohort study

2020 ◽  
Author(s):  
Chun-Ting Yang ◽  
Kuan-Ying Li ◽  
Chen-Yi Yang ◽  
Huang-Tz Ou ◽  
Shihchen Kuo
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Real World ◽  
Basal Insulin ◽  
Lower Risk ◽  
Insulin Analogue ◽  
Population Based ◽  
Acting Insulin ◽  
Long Acting

Abstract Background: Little is known about the comparative vascular safety of basal insulin (intermediate-acting human insulin [IAHI] or long-acting insulin analogue [LAIA]) in type 2 diabetes. We sought to examine the vascular and hypoglycemic effects associated with IAHI versus LAIA in real-world patients with type 2 diabetes. Methods: We conducted a nationwide population-based, retrospective cohort study using Taiwan’s National Health Insurance Research Database to include patients with type 2 diabetes who stably used an IAHI (N=11,521) or LAIA (N=37,651) in the period 2004-2012. A rigorous three-step matching algorithm that considered the initiation date of basal insulin, previous exposure of antidiabetic treatments, comorbidities, diabetes severity and complications, and concomitant medications was applied to achieve the between-group comparability. Study outcomes, including composite cardiovascular diseases (CVDs), composite microvascular diseases (MVDs), and hypoglycemia, were assessed up to the end of 2013. Results: Baseline patient characteristics were balanced with the application of the matching scheme. Compared with LAIA, the use of IAHI was associated with greater risks of composite CVDs (adjusted hazard ratio: 1,79; 95% confidence interval: 1.20-2.67) and hospitalized hypoglycemia (1.82; 1.51-2.20), but a lower risk of composite MVDs (0.88; 0.84-0.91). Subgroup and sensitivity analyses showed a consistent trend of results with that in the primary analyses. Conclusions: The use of a basal insulin with IAHI versus LAIA among patients with type 2 diabetes in usual practice may be associated with a lower risk of MVDs, and strategies should be optimized for minimizing the risks of hypoglycemia and CVDs in this population.

scholarly journals Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis

2020 ◽  
Author(s):  
Kai-Cheng Chang ◽  
Shih-Chieh Shao ◽  
Shihchen Kuo ◽  
Chen-Yi Yang ◽  
Hui-Yu Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Real World ◽  
Comparative Effectiveness ◽  
Blood Pressure Reduction ◽  
Renal Functions ◽  
Diabetes Patients

Abstract Background Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide. Methods We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016-2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every three months in the one-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches. Results A total of 1,512 subjects receiving dulaglutide and 1,513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: -1.06%, p<0.001; liraglutide: -0.83%, p<0.001), with a significant between-group difference (-0.23%, 95% confidence interval: -0.38 to -0.08%, p<0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: -1.14 kg, -3.08 U/L and -2.08 ml/min/1.73 m2, p<0.01; liraglutide: -1.64 kg, -3.65 U/L and -2.33 ml/min/1.73 m2, p<0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (-2.47 mmHg, p<0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant. Conclusions In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.

64-LB: Glucose Control after Initiation of Flash Glucose Monitoring in Type 2 Diabetes Managed with Basal Insulin: A Retrospective Real-World Chart Review Study from the U.S.

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 64-LB
Author(s):  
ANDERS L. CARLSON ◽  
TIMOTHY D. DANIEL ◽  
ANDREA DESANTIS ◽  
SERGE JABBOUR ◽  
ESRA KARSLIOGLU-FRENCH ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Real World ◽  
Glucose Control ◽  
Basal Insulin ◽  
Chart Review ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Review Study ◽  
The U.S
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