Document Detail


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.
MedLine Citation:
PMID:  20979936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Pfohl; F-W Dippel; K Kostev; S Fuchs; W Kotowa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2010-10-28     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423309     Medline TA:  Int J Clin Pharmacol Ther     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  761-6     Citation Subset:  IM    
Affiliation:
Evangelisches Bethesda-Johanniter-Klinikum GmbH, Duisburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
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:
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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