ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2014
Early discontinuation and restart of insulin in the treatment of type 2 diabetes mellitus.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review.Diabetes, obesity & metabolism · 2022Pooled it
- A Systematic Review of Insulin Adherence Measures in Patients with Diabetes.Journal of managed care & specialty pharmacy · 2016Pooled it
- Pharmacological and Benefit-Risk Profile of Once-Weekly Basal Insulin Administration (Icodec): Addressing Patients' Unmet Needs and Exploring Future Applications.Journal of clinical medicine · 2024Review
- Persistence to Basal Insulin: Association With Health Outcomes in a Population With Type 2 Diabetes.Clinical diabetes : a publication of the American Diabetes Association · 2024Article
- Adherence and Persistence to Insulin Therapy in People with Diabetes: Impact of Connected Insulin Pen Delivery Ecosystem.Journal of diabetes science and technology · 2022Review
- Effect of Diabetes-Trained Nurse Practitioners on Glycemic Outcomes: Their Suggested Use in Busy Primary Care Practices.Clinical diabetes : a publication of the American Diabetes Association · 2021Article
- Diabetes, Body Fatness, and Insulin Prescription Among Adolescents and Young Adults with Cancer.Journal of adolescent and young adult oncology · 2021Article
- Persistence with Basal Insulin and Frequency of Hypoglycemia Requiring Hospitalization in Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Article
- Treatment Patterns, Adherence, and Persistence Associated With Human Regular U-500 Insulin: A Real-World Evidence Study.Diabetes spectrum : a publication of the American Diabetes Association · 2020Article
- Treatment Patterns and Characteristics of Individuals Initiating High-Dose Insulin for Type 2 Diabetes Mellitus.Journal of managed care & specialty pharmacy · 2020Observational
- The importance of the initial period of basal insulin titration in people with diabetes.Diabetes, obesity & metabolism · 2020Review
- Factors and outcomes associated with discontinuation of basal insulin therapy in patients with type 2 diabetes mellitus.Endocrinology, diabetes & metabolism · 2020Article
- Basal Insulin Initiation and Maintenance in Adults with Type 2 Diabetes Mellitus in the United States.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020Article
- Injectable Antihyperglycemics: A Systematic Review and Critical Analysis of the Literature on Adherence, Persistence, and Health Outcomes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
- Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Review
- A comparative effectiveness study of degludec and insulin glargine 300 U/mL in insulin-naïve patients with type 2 diabetes.Diabetes, obesity & metabolism · 2019Observational
- Effect of Remote Glucose Monitoring Utilizing Computerized Insulin Dose Adjustment Algorithms: A Pilot Project.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Article
- Insights into optimal basal insulin titration in type 2 diabetes: Results of a quantitative survey.Diabetes, obesity & metabolism · 2018Article
- Physicians' real-world experience with IDegLira: results of a European survey.BMJ open diabetes research & care · 2018Article
- Treatment Discontinuation and Clinical Events in Type 2 Diabetes Patients Treated with Dipeptidyl Peptidase-4 Inhibitors or NPH Insulin as Third-Line Therapy.Journal of diabetes research · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough the largest improvement in glycemic control occurs within the first 90 days of insulin therapy, little is known about early persistence on insulin therapy. This research aimed to identify predictors of early discontinuation and of subsequent restart of basal or mixture insulin among patients with type 2 diabetes mellitus (T2DM) and to assess the economic cost associated with such behaviors over a 1-year period.
methodsTruven's Health Analytics Commercial Claims and Encounters database was utilized for the study. Logistic regressions were used to examine factors associated with early discontinuation of insulin (basal or mixture) and, among patients who discontinued early, the factors associated with restarting. Cost regressions were estimated using generalized linear models with a gamma distribution and logistic link. Kaplan-Meier survival curves were used to examine time to discontinuation and time to restart among those who discontinued.
resultsMultivariate analyses revealed that patient characteristics, prior healthcare resource utilization, comorbid diagnoses, and type of initiated insulin were associated with early discontinuation of insulin and of restarting among patients who discontinued early. Acute care (hospitalization and emergency room) costs were 9.6% higher among patients who discontinued early (P < 0.001), although outpatient, drug, and total costs were significantly lower among individuals who discontinued early. Among the early discontinuation subgroup, restarting insulin was associated with higher costs. Specifically: 11.3% higher acute care costs (P < 0.001), 24.0% higher outpatient costs (P < 0.001), 80.2% higher drug costs (P < 0.001), and 30.3% higher total costs (P < 0.001), compared to patients who discontinued early but did not restart insulin therapy in the 1-year post-period.
conclusionAmong patients with T2DM who were initiated on insulin therapy, early discontinuation of insulin and its subsequent restart were associated with significantly higher acute care costs, which may signal a more complex and challenging subgroup of patients who tend to be less engaged in outpatient care and may have poorer long-term outcomes.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.