TY - JOUR
T1 - Effectiveness of premixed insulin to achieve glycaemic control in type 2 diabetes
T2 - A retrospective UK cohort study
AU - Jude, Edward B.
AU - Trescoli, Carlos
AU - Emral, Rifat
AU - Ali, Amar
AU - Lubwama, Robert
AU - Palmer, Karen
AU - Shaunik, Alka
AU - Nanda, Nithya
AU - Raskin, Philip
AU - Gomez-Peralta, Fernando
N1 - Funding Information:
The authors would like to thank Ana Merino-Trigo, PhD (Sanofi) for co-ordinating the development, facilitating author discussions and review of this manuscript. Editorial assistance was provided by Tamsin Brown, MSc, and Jo Bentley, PhD, of Fishawack Communications Ltd, and was funded by Sanofi. All the authors take complete responsibility for the interpretation of the data in this paper. These data were previously partially presented at the 80th American Diabetes Association Scientific Sessions virtual meeting, 12-16 June 2020, and at the 56th annual meeting of the European Association for the Study of Diabetes (EASD) virtual meeting, 21-25 September 2020. This study was funded by Sanofi, Paris, France. The funder of the study was involved in the study design; data collection, analysis and interpretation; and writing of the report.
Funding Information:
The authors would like to thank Ana Merino‐Trigo, PhD (Sanofi) for co‐ordinating the development, facilitating author discussions and review of this manuscript. Editorial assistance was provided by Tamsin Brown, MSc, and Jo Bentley, PhD, of Fishawack Communications Ltd, and was funded by Sanofi. All the authors take complete responsibility for the interpretation of the data in this paper. These data were previously partially presented at the 80th American Diabetes Association Scientific Sessions virtual meeting, 12‐16 June 2020, and at the 56th annual meeting of the European Association for the Study of Diabetes (EASD) virtual meeting, 21‐25 September 2020. This study was funded by Sanofi, Paris, France. The funder of the study was involved in the study design; data collection, analysis and interpretation; and writing of the report.
Publisher Copyright:
© 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2021/4
Y1 - 2021/4
N2 - Aim: To investigate the effectiveness of premixed insulin for achieving glycaemic outcomes in clinical practice in the UK. Materials and Methods: Electronic medical record data from The Health Improvement Network database were captured for adults with type 2 diabetes (T2D) uncontrolled (HbA1c ≥9%) on two or more oral antihyperglycaemic drugs (OADs) initiating premixed insulin. Effectiveness of premixed insulin was assessed by the probability and incidence of achieving glycaemic outcomes (target HbA1c <7.5% [<58 mmol/mol] and a ≥1% or ≥2% HbA1c reduction) over 24 months. Results: Data from 974 participants (mean age 62 years; 56% male; 52% obese or extremely obese; mean HbA1c 11.3% [100 mmol/mol]; hypertension 64%, dyslipidaemia 23% and nephropathy 21%) were analysed. The probability of achieving HbA1c <7.5% was highest during months 3-6 (18.2%), while the cumulative probability of achieving this target plateaued between months 15-24 (15.7%-16.0%). Incidence of achieving all glycaemic outcomes plateaued after 12 months and differed by baseline HbA1c, but not OAD use. Factors affecting some glycaemic outcomes included a body mass index >40 kg/m2 and co-morbidities including nephropathy and stroke. Conclusions: In people with uncontrolled T2D (HbA1c ≥9%), glycaemic outcome achievement on premixed insulin was low at 6 months with little additional clinical benefit beyond 12 months, suggesting a high unmet need for early, timely treatment changes with more effective, simpler therapies.
AB - Aim: To investigate the effectiveness of premixed insulin for achieving glycaemic outcomes in clinical practice in the UK. Materials and Methods: Electronic medical record data from The Health Improvement Network database were captured for adults with type 2 diabetes (T2D) uncontrolled (HbA1c ≥9%) on two or more oral antihyperglycaemic drugs (OADs) initiating premixed insulin. Effectiveness of premixed insulin was assessed by the probability and incidence of achieving glycaemic outcomes (target HbA1c <7.5% [<58 mmol/mol] and a ≥1% or ≥2% HbA1c reduction) over 24 months. Results: Data from 974 participants (mean age 62 years; 56% male; 52% obese or extremely obese; mean HbA1c 11.3% [100 mmol/mol]; hypertension 64%, dyslipidaemia 23% and nephropathy 21%) were analysed. The probability of achieving HbA1c <7.5% was highest during months 3-6 (18.2%), while the cumulative probability of achieving this target plateaued between months 15-24 (15.7%-16.0%). Incidence of achieving all glycaemic outcomes plateaued after 12 months and differed by baseline HbA1c, but not OAD use. Factors affecting some glycaemic outcomes included a body mass index >40 kg/m2 and co-morbidities including nephropathy and stroke. Conclusions: In people with uncontrolled T2D (HbA1c ≥9%), glycaemic outcome achievement on premixed insulin was low at 6 months with little additional clinical benefit beyond 12 months, suggesting a high unmet need for early, timely treatment changes with more effective, simpler therapies.
KW - database research, glycaemic control, insulin therapy, type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85099943287&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099943287&partnerID=8YFLogxK
U2 - 10.1111/dom.14298
DO - 10.1111/dom.14298
M3 - Article
C2 - 33319424
AN - SCOPUS:85099943287
SN - 1462-8902
VL - 23
SP - 929
EP - 937
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
IS - 4
ER -