| Different persistence on initial basal supported oral therapy in Type 2 diabetics is associated with unequal distributions of insulin treatment regimens under real-life conditions in Germany. | |
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MedLine Citation:
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PMID: 20979936 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Results from a representative German database and from two German health services research studies revealed an unequal distribution between basal supported oral therapy (BOT) and basal-bolus therapy (ICT) regimens in Type 2 diabetics treated with either insulin glargine (GLA) or human insulin (Neutral Protamine Hagedorn; NPH). This study assesses whether this unequal distribution could be caused by a different persistence on the initial BOT regimen. METHODS: A Markov model was developed simulating the transition from BOT to ICT during a treatment course of 10 years. Data on persistence with BOT were obtained from the IMS® Disease Analyzer database. The model cohort consisted of German statutorily insured Type 2 diabetics starting a BOT either with insulin glargine or NPH insulin at a ratio of 1 : 1. RESULTS: The number of Type 2 diabetics who switched from BOT to ICT differed between the two groups: After 2 years, 53% of glargine-treated patients and 31% of NPH-treated patients continued the BOT. After 6.5 years, all NPH-treated patients had switched to ICT. However, complete transition to ICT of glargine-treated patients occurred 1.75 years later. In the first quarter of Year 3, the model simulation resulted in BOT : ICT ratios comparable to those found in the real-world settings for GLA- and NPH-treated patients. CONCLUSIONS: The simulation indicates that the persistence on the initial basal supported oral therapy is associated with the resulting BOT : ICT ratio. Therefore, the unequal distribution between BOT and ICT of Type 2 diabetics treated with either insulin glargine or NPH insulin might be caused by different persistence on the initial BOT regimen. |
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Authors:
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M Pfohl; F-W Dippel; K Kostev; S Fuchs; W Kotowa |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of clinical pharmacology and therapeutics Volume: 48 ISSN: 0946-1965 ISO Abbreviation: Int J Clin Pharmacol Ther Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-28 Completed Date: 2011-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423309 Medline TA: Int J Clin Pharmacol Ther Country: Germany |
Other Details:
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Languages: eng Pagination: 761-6 Citation Subset: IM |
Affiliation:
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Evangelisches Bethesda-Johanniter-Klinikum GmbH, Duisburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Aged Databases, Factual Diabetes Mellitus, Type 2 / drug therapy* Female Germany Humans Hypoglycemic Agents / administration & dosage, therapeutic use* Insulin / administration & dosage, analogs & derivatives*, therapeutic use Insulin, NPH / administration & dosage, therapeutic use* Male Markov Chains Middle Aged Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 0/glargine; 11061-68-0/Insulin; 53027-39-7/Insulin, NPH |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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