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IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy

AIMS: Basal–bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal–bolus therapy on number of injections, dose adjustments and patien...

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Autores principales: Miller, Eden, Doshi, Ankur, Grøn, Randi, Jódar, Esteban, Őrsy, Petra, Ranthe, Mattis F., Sugimoto, Danny, Tentolouris, Nikolaos, Viljoen, Adie, Billings, Liana K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899651/
https://www.ncbi.nlm.nih.gov/pubmed/31385425
http://dx.doi.org/10.1111/dom.13851
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author Miller, Eden
Doshi, Ankur
Grøn, Randi
Jódar, Esteban
Őrsy, Petra
Ranthe, Mattis F.
Sugimoto, Danny
Tentolouris, Nikolaos
Viljoen, Adie
Billings, Liana K.
author_facet Miller, Eden
Doshi, Ankur
Grøn, Randi
Jódar, Esteban
Őrsy, Petra
Ranthe, Mattis F.
Sugimoto, Danny
Tentolouris, Nikolaos
Viljoen, Adie
Billings, Liana K.
author_sort Miller, Eden
collection PubMed
description AIMS: Basal–bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal–bolus therapy on number of injections, dose adjustments and patient outcomes in the DUAL VII trial. MATERIALS AND METHODS: DUAL VII was a 26‐week, open‐label trial in which patients with uncontrolled type 2 diabetes who were using metformin and insulin glargine 100 units/mL (20–50 U) were randomized 1:1 to IDegLira (N = 252) or basal–bolus (insulin glargine U100 + insulin aspart ≤4 times/day) (N = 254). This post hoc analysis reports the observed mean number of injections and cumulative dose adjustments during 26 weeks of treatment. Patient‐reported outcomes (Treatment‐Related Impact Measure – Diabetes [TRIM‐D] and Short Form‐36 Health Survey version 2 [SF‐36v2]) were collected at scheduled visits and change from baseline scores calculated. RESULTS: The clinical benefits (non‐inferior HbA1c reductions, weight benefit, less hypoglycaemia) of IDegLira vs basal–bolus therapy were achieved with fewer cumulative dose adjustments (16.6 vs 217.2, respectively) and fewer injections (1 vs ≥3 per day, respectively). Patients treated with IDegLira experienced significant improvements across all TRIM‐D domains compared with those undergoing basal–bolus therapy. The SF‐36v2 showed improvements in both treatment arms with no significant difference between arms in the physical component summary, but there was a significant improvement in patients treated with IDegLira in the mental component summary (P = .0228). CONCLUSIONS: These findings, combined with the DUAL VII results, suggest that IDegLira, through a more simplified regimen versus basal–bolus therapy, may help improve patient adherence and improve patient outcomes related to diabetes management, treatment burden and mental health, which in turn may assist in the timely achievement of glycaemic control in clinical practice.
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spelling pubmed-68996512019-12-19 IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy Miller, Eden Doshi, Ankur Grøn, Randi Jódar, Esteban Őrsy, Petra Ranthe, Mattis F. Sugimoto, Danny Tentolouris, Nikolaos Viljoen, Adie Billings, Liana K. Diabetes Obes Metab Original Articles AIMS: Basal–bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal–bolus therapy on number of injections, dose adjustments and patient outcomes in the DUAL VII trial. MATERIALS AND METHODS: DUAL VII was a 26‐week, open‐label trial in which patients with uncontrolled type 2 diabetes who were using metformin and insulin glargine 100 units/mL (20–50 U) were randomized 1:1 to IDegLira (N = 252) or basal–bolus (insulin glargine U100 + insulin aspart ≤4 times/day) (N = 254). This post hoc analysis reports the observed mean number of injections and cumulative dose adjustments during 26 weeks of treatment. Patient‐reported outcomes (Treatment‐Related Impact Measure – Diabetes [TRIM‐D] and Short Form‐36 Health Survey version 2 [SF‐36v2]) were collected at scheduled visits and change from baseline scores calculated. RESULTS: The clinical benefits (non‐inferior HbA1c reductions, weight benefit, less hypoglycaemia) of IDegLira vs basal–bolus therapy were achieved with fewer cumulative dose adjustments (16.6 vs 217.2, respectively) and fewer injections (1 vs ≥3 per day, respectively). Patients treated with IDegLira experienced significant improvements across all TRIM‐D domains compared with those undergoing basal–bolus therapy. The SF‐36v2 showed improvements in both treatment arms with no significant difference between arms in the physical component summary, but there was a significant improvement in patients treated with IDegLira in the mental component summary (P = .0228). CONCLUSIONS: These findings, combined with the DUAL VII results, suggest that IDegLira, through a more simplified regimen versus basal–bolus therapy, may help improve patient adherence and improve patient outcomes related to diabetes management, treatment burden and mental health, which in turn may assist in the timely achievement of glycaemic control in clinical practice. Blackwell Publishing Ltd 2019-08-28 2019-12 /pmc/articles/PMC6899651/ /pubmed/31385425 http://dx.doi.org/10.1111/dom.13851 Text en © 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Miller, Eden
Doshi, Ankur
Grøn, Randi
Jódar, Esteban
Őrsy, Petra
Ranthe, Mattis F.
Sugimoto, Danny
Tentolouris, Nikolaos
Viljoen, Adie
Billings, Liana K.
IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title_full IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title_fullStr IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title_full_unstemmed IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title_short IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
title_sort ideglira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899651/
https://www.ncbi.nlm.nih.gov/pubmed/31385425
http://dx.doi.org/10.1111/dom.13851
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