One in Seven Insulin-Treated Patients in Developing Countries Reported Poor Persistence with Insulin Therapy: Real World Evidence from the Cross-Sectional International Diabetes Management Practices Study (IDMPS)
| Autor: | Jean-Marc Chantelot, Marina Vladimirovna Shestakova, Fernando Lavalle, Pablo Aschner, Ambady Ramachandran, Cecile Dessapt-Baradez, Hasan Ilkova, Jean Claude Mbanya, Juliana C.N. Chan, Juan José Gagliardino |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty endocrine system Type-2 endocrine system diseases medicine.medical_treatment Developing country Glycemic Control Outcomes Type 2 diabetes Care Medication Healthcare delivery Real world evidence Education Persistence (computer science) Association Diabetes management Internal medicine medicine Humans Hypoglycemic Agents Insulin Pharmacology (medical) Mortality Developing Countries Original Research business.industry nutritional and metabolic diseases Clinical science and care General Medicine medicine.disease Rheumatology Discontinuation Cross-Sectional Studies Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Adherence Insulin therapy business Barriers |
| Zdroj: | Advances in Therapy |
| ISSN: | 1865-8652 0741-238X |
| Popis: | IntroductionAlthough poor adherence to insulin is widely recognised, periodic discontinuation of insulin may cause more severe hyperglycaemia than poor adherence. We assessed persistence with insulin therapy in patients with type 1 (T1D) or type 2 diabetes (T2D) in developing countries and the reasons for insulin discontinuation.MethodsThe International Diabetes Management Practices Study collected real-world data from developing countries in seven waves between 2005 and 2017. In Wave 7 (2016-2017), we asked adult patients with T1D and insulin-treated T2D to report whether they had ever discontinued insulin, the estimated duration of discontinuation and underlying reasons.ResultsAmong 8303 patients recruited from 24 countries by 620 physicians, 4596 were insulin-treated (T1D: 2000; T2D: 2596). In patients with T1D, 14.0% (95% CI: 12.5-15.6) reported having self-discontinued insulin for a median duration of 1.0 month (IQR: 0.5, 3.5). The respective figures in patients with T2D were 13.7% (12.4-15.1) and 2.0 months (IQR: 1.0, 6.0). The main reasons for discontinuation were impact on social life (T1D: 41.0%; T2D: 30.5%), cost of medications and test strips (T1D: 34.4%; T2D: 24.5%), fear of hypoglycaemia (T1D: 26.7%; T2D: 28.0%) and lack of support (T1D: 26.4%; T2D: 25.9%). Other factors included age < 40 years, non-university education and short disease duration (T1D: 1- 75 mmol/mol (> 9%) and > 50% of physicians recommended diabetes education programmes to improve treatment persistence.ConclusionIn developing countries, poor persistence with insulin is common among insulin-treated patients, supporting calls for urgent actions to ensure easy access to insulin, tools for SMBG and education. Sanofi (Paris, France); Sanofi This study was funded by Sanofi (Paris, France). The sponsor was supported by the steering committee regarding study design, registry structure, protocol amendments, research questions, analyses and publications. Publication fees (including the journal's Rapid Service and Open Access fees) were also funded by Sanofi. |
| Databáze: | OpenAIRE |
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