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Basal insulin initiation and maintenance in adults with type 2 diabetes mellitus in the United States

Diabetes, Metabolic Syndrome and Obesity, ISSN: 1178-7007, Vol: 13, Page: 1023-1033
2020
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Metric Options:   Counts1 Year3 Year

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Article Description

Objective: A survey of US adults with type 2 diabetes mellitus was conducted to better understand patients’ insulin initiation experiences and treatment persistence behaviors. Research Design and Methods: Participants were recruited from consumer panels and grouped by basal insulin treatment pattern: continuers (no gap of ≥7 days within 6 months of initiation); interrupters (gap ≥7 days, resumed treatment); discontinuers (stopped for ≥7 days, not resumed). A quota of approximately 50 respondents per persistence category was set. Results: A total of 154 respondents (52 continuers, 52 interrupters, 50 discontinuers) completed the survey. Mean age was 51.4 years; 51.9% male. Continuers were more likely to report their views being considered during initiation, and less likely to report a sense of failure. Concerns included insulin dependence (64.3% agree/strongly agree), frequent blood glucose monitoring (55.2%), costs/ability to pay (53.9%), fears of or mistakes during self-injection (52.6%), and weight gain (52.6%). Continuers were motivated by benefits of insulin therapy; experienced or potential side effects were notable factors for interruption/discontinuation. Healthcare provider instruction was indicated as a reason for continuing, stopping, and restarting therapy. Conclusion: Benefits of basal insulin therapy motivated continuers while side effects impacted interruption/discontinuation. Persistence on basal insulin is often influenced by provider actions. Earlier provider intervention upon signs of treatment discontinuation may promote persistence.

Bibliographic Details

Kalirai, Samaneh; Ivanova, Jasmina I; Perez-Nieves, Magaly; Stephenson, Judith J; Hadjiyianni, Irene; Grabner, Michael; Pollom, Roy Daniel; Geremakis, Caroline; Reed, Beverly L; Fisher, Lawrence

Informa UK Limited

Medicine; Pharmacology, Toxicology and Pharmaceutics

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