Profile Evaluation of Medication, Cost Comparison, and Clinical Outcome of Human and Analog Insulin Treatment to Type-2 Diabetes Mellitus Outpatient at Medistra Hospital Year 2012-2013

The data collection was conducted retrospectively, taking samples of 121 outpatients, of which 83 outpatients were evaluated for their clinical outcome. The medication profile data were collected from the medicine administration at the Hospital Pharmacy Installation. The clinical outcome data, such as fasting plasma glucose (FPG), two-hour postprandial plasma glucose (2HPP), and Hemoglobin A1c (HbA1c), were garnered from the patients’ medical records. The cost data were collected from the outpatients’ payment receipts provided by the Hospital’s Financial Department. Kolmogorov Smirnov normality test was applied in this research. The research result suggests that after Mann Whitney Test, the human and analogue insulin were not significantly different seen from the clinical outcome result showing FPG (p=0.676), 2HPP (p=0.175), HbA1c (p=0.0445) and from the cost result (p=0.795). Furthermore, the research also shows that the average cost of 30-day medication of single human insulin was Rp3,190,997.43, while the one of analogue insulin was Rp3,188,832.35. In conclusion, the research finds out that if seen from the cost (p=0.795), the human and the analogue insulin were not significantly different.

Efficacy, Safety, and Quality of Treatment Satisfaction of Premixed Human and Analogue Insulin Regimens in a Large Cohort of Type 2 Diabetic Patients: PROGENS BENEFIT Observational Study

Diabetes is a lifelong course disease, so insulin treatment has to be effective and safe, and patients should be satisfied with it. We aimed to compare efficacy, safety, and quality of treatment satisfaction of human and premixed analogue insulin among 3264 patients (53.58% women) with type 2 diabetes mellitus (T2DM) in a real-life environment. 2493 patients (62.77%) had been assigned to group I where before the inclusion into the study the treatment regimen has been changed from analogue to human premixed insulin and 771 patients (37.23%) to group II where the treatment with insulin analogue remained unchanged. At the end of the study, there was a reduction of HbA1c observed in both of the groups; however, Δ HbA1c was significantly higher in group 1 (−0.599 versus −0.406; P<0.001 at visit 3 versus visit 1). The number of hypoglycemic episodes during the study observation was insignificantly reduced in both groups. Diabetes treatment satisfaction measured with DTSQ increased at the end of the study and was significantly better in group I compared to group II (P<0.001). This observational study proved that both human and premixed analogue insulin are effective and safe, and patients are satisfied with the treatment.

Clinical experiences with basal analogue insulin in routine care. Retrospective follow up analysis of a database from daily routine care

Introduction: Basal-bolus insulin regime is frequently used in type 2 diabetes in order to improve metabolic control and decrease the risk of complications. A general question is, however, the effect of application of analogue insulin in comparison to human insulin regimes. Aim: The aim of the authors was to perform a retrospective database analysis among patients who were switched from human insulin only based basal-bolus regime to analogue only insulin regime in order to examine changes in metabolic control, body weight, insulin dose and basal:bolus insulin ratio. Method: Type 2 diabetic patients (n = 137) were enrolled who used once daily basal insulin with complementary bolus insulin given at main meals, and human insulin was switched to analogue insulin. Patients were divided into two groups using detemir (n = 103) or glargine (n = 34). Results: During 17 months ofanalogue insulin treatment the HbA1c was decreased by 0.34% (detemir –0.44%; glargine –0.17%). Body weight was increased by 1.11 kg (detemir +1.0 kg; glargine +1.43 kg). The basal:bolus insulin ratio increased in all groups (entire cohort 6.04%, detemir 5.26%, glargine 8.37%). The average insulin dose was 80.76 units at the end of follow up. There was no significant difference in terms of total and basal insulin doses between detemir (27.89 and 79.78 U, respectively) and glargine group (32.85 and 83.74 U, respectively). Conclusions: These results support that switching from human to analogue insulin in basal-bolus regime could improve the metabolic control by increasing dose of basal analogue insulin and basal: bolus ratio. Both detemir and glargine can provide similar improvement in metabolic control with the same insulin dose but with relatively more weight gain with glargine. Orv. Hetil., 2013, 154, 1476–1484.