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2型糖尿病患者基础胰岛素类似物治疗持续使用的相关因素:来自英国真实世界样本的探索性分析。

Associated factors that influenced persistence with basal analog insulin therapy among people with type 2 diabetes: An exploratory analysis from a UK real-world sample.

作者信息

Idris Iskandar, Gulati Kunal, Perez-Nieves Magaly, Hadjiyianni Irene, Cao Dachuang, Tahbaz Arash, Ivanova Jasmina, Hassan Syed Wasi

机构信息

Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK.

Eli Lilly and Company, Basingstoke, UK.

出版信息

Prim Care Diabetes. 2019 Apr;13(2):106-112. doi: 10.1016/j.pcd.2018.09.002. Epub 2018 Nov 23.

DOI:10.1016/j.pcd.2018.09.002
PMID:30477969
Abstract

AIM

Real-world effectiveness of insulin therapy is affected by poor treatment persistence, often occurring soon after initiation. An international cross-sectional survey of people with type 2 diabetes mellitus (T2DM) has been conducted to describe reasons for non-persistence with insulin therapy.

METHODS

Responders to an online survey in 7 countries were classified as continuers (no gap of ≥7days), interrupters (interrupted therapy for ≥7days within first 6 months, then restarted), and discontinuers (terminated therapy for ≥7days within first 6 months, no restart before survey). We present the results from the United Kingdom (UK) cohort.

RESULTS

Of 942 global respondents, 131 were from the UK, having a mean age of 37years and a mean of 7years since first T2DM diagnosis. Reasons contributing to insulin continuation (n=50) were improved physical feeling (52.0%) and improved glycemic control (48.0%). Common reasons for interruption (n=50) or discontinuation (n=31), respectively were weight gain (50.0%, 48.4%) and hypoglycemia (38.0%, 25.8%). Most important reason for possible re-initiation for interrupters and discontinuers, respectively was persuasion by physician/healthcare professional (74.0%, 64.5%).

CONCLUSION

The benefits of basal insulin therapy motivated continuers to persist with the treatment; experienced or anticipated side effects contributed to interruption and discontinuation.

摘要

目的

胰岛素治疗的实际效果受到治疗依从性差的影响,这种情况常在治疗开始后不久就会出现。开展了一项针对2型糖尿病(T2DM)患者的国际横断面调查,以描述胰岛素治疗不依从的原因。

方法

对7个国家在线调查的受访者进行分类,分为持续使用者(无≥7天的治疗中断)、中断使用者(在最初6个月内中断治疗≥7天,然后重新开始)和停止使用者(在最初6个月内终止治疗≥7天,在调查前未重新开始)。我们展示了英国队列的结果。

结果

在942名全球受访者中,131名来自英国,平均年龄为37岁,自首次诊断T2DM以来平均患病7年。胰岛素持续使用(n = 50)的原因是身体感觉改善(52.0%)和血糖控制改善(48.0%)。中断使用(n = 50)或停止使用(n = 31)的常见原因分别是体重增加(50.0%,48.4%)和低血糖(38.0%,25.8%)。中断使用者和停止使用者可能重新开始使用胰岛素的最重要原因分别是医生/医护人员的劝说(74.0%,64.5%)。

结论

基础胰岛素治疗的益处促使持续使用者坚持治疗;经历过的或预期的副作用导致了治疗中断和停止。

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