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Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications
INTRODUCTION: Insulin analog glargine (GLA) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control. Studies have shown that a decrease in the frequency of hypoglycemic episodes improves the quality of life (QoL) of diabetic patient...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019415/ https://www.ncbi.nlm.nih.gov/pubmed/29322308 http://dx.doi.org/10.1007/s40271-017-0291-3 |
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author | Almeida, Paulo H. R. F. Silva, Thales B. C. de Assis Acurcio, Francisco Guerra Júnior, Augusto A. Araújo, Vania E. Diniz, Leonardo M. Godman, Brian Almeida, Alessandra M. Alvares, Juliana |
author_facet | Almeida, Paulo H. R. F. Silva, Thales B. C. de Assis Acurcio, Francisco Guerra Júnior, Augusto A. Araújo, Vania E. Diniz, Leonardo M. Godman, Brian Almeida, Alessandra M. Alvares, Juliana |
author_sort | Almeida, Paulo H. R. F. |
collection | PubMed |
description | INTRODUCTION: Insulin analog glargine (GLA) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control. Studies have shown that a decrease in the frequency of hypoglycemic episodes improves the quality of life (QoL) of diabetic patients. However, there are appreciable acquisition cost differences between different insulins. Consequently, there is a need to assess their impact on QoL to provide future guidance to health authorities. METHOD: A systematic review of multiple databases including Medline, LILACS, Cochrane, and EMBASE databases with several combinations of agreed terms involving randomized controlled trials and cohorts, as well as manual searches and gray literature, was undertaken. The primary outcome measure was a change in QoL. The quality of the studies and the risk of bias was also assessed. RESULTS: Eight studies were eventually included in the systematic review out of 634 publications. Eight different QoL instruments were used (two generic, two mixed, and four specific), in which the Diabetes Treatment Satisfaction Questionnaire (DTSQ) was the most used. The systematic review did not consistently show any significant difference overall in QoL scores, whether as part of subsets or combined into a single score, with the use of GLA versus neutral protamine Hagedorn (NPH) insulin. Only in patient satisfaction measured by DTSQ was a better result consistently seen with GLA versus NPH insulin, but not using the Well-being Inquiry for Diabetics (WED) scale. However, none of the cohort studies scored a maximum on the Newcastle–Ottawa scale for quality, and they generally were of moderate quality with bias in the studies. CONCLUSION: There was no consistent difference in QoL or patient-reported outcomes when the findings from the eight studies were collated. In view of this, we believe the current price differential between GLA and NPH insulin in Brazil cannot be justified by these findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40271-017-0291-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6019415 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-60194152018-07-11 Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications Almeida, Paulo H. R. F. Silva, Thales B. C. de Assis Acurcio, Francisco Guerra Júnior, Augusto A. Araújo, Vania E. Diniz, Leonardo M. Godman, Brian Almeida, Alessandra M. Alvares, Juliana Patient Systematic Review INTRODUCTION: Insulin analog glargine (GLA) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control. Studies have shown that a decrease in the frequency of hypoglycemic episodes improves the quality of life (QoL) of diabetic patients. However, there are appreciable acquisition cost differences between different insulins. Consequently, there is a need to assess their impact on QoL to provide future guidance to health authorities. METHOD: A systematic review of multiple databases including Medline, LILACS, Cochrane, and EMBASE databases with several combinations of agreed terms involving randomized controlled trials and cohorts, as well as manual searches and gray literature, was undertaken. The primary outcome measure was a change in QoL. The quality of the studies and the risk of bias was also assessed. RESULTS: Eight studies were eventually included in the systematic review out of 634 publications. Eight different QoL instruments were used (two generic, two mixed, and four specific), in which the Diabetes Treatment Satisfaction Questionnaire (DTSQ) was the most used. The systematic review did not consistently show any significant difference overall in QoL scores, whether as part of subsets or combined into a single score, with the use of GLA versus neutral protamine Hagedorn (NPH) insulin. Only in patient satisfaction measured by DTSQ was a better result consistently seen with GLA versus NPH insulin, but not using the Well-being Inquiry for Diabetics (WED) scale. However, none of the cohort studies scored a maximum on the Newcastle–Ottawa scale for quality, and they generally were of moderate quality with bias in the studies. CONCLUSION: There was no consistent difference in QoL or patient-reported outcomes when the findings from the eight studies were collated. In view of this, we believe the current price differential between GLA and NPH insulin in Brazil cannot be justified by these findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40271-017-0291-3) contains supplementary material, which is available to authorized users. Springer International Publishing 2018-01-10 2018 /pmc/articles/PMC6019415/ /pubmed/29322308 http://dx.doi.org/10.1007/s40271-017-0291-3 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Systematic Review Almeida, Paulo H. R. F. Silva, Thales B. C. de Assis Acurcio, Francisco Guerra Júnior, Augusto A. Araújo, Vania E. Diniz, Leonardo M. Godman, Brian Almeida, Alessandra M. Alvares, Juliana Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title | Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title_full | Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title_fullStr | Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title_full_unstemmed | Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title_short | Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications |
title_sort | quality of life of patients with type 1 diabetes mellitus using insulin analog glargine compared with nph insulin: a systematic review and policy implications |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019415/ https://www.ncbi.nlm.nih.gov/pubmed/29322308 http://dx.doi.org/10.1007/s40271-017-0291-3 |
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