Evaluation of insulin initiation on resource utilization and direct costs of treatment over 12 months in patients with type 2 diabetes in Europe: results from INSTIGATE and TREAT observational studies

Brismar, Kerstin; Benroubi, Marian; Nicolay, Claudia; Schmitt, H; Giaconia, Joseph M.; Reaney, Matthew

doi:10.3111/13696998.2013.812040

Cited by 7 publications

(19 citation statements)

References 25 publications

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“…Two recent meta‐analyses also suggest that basal‐plus or basal‐bolus insulin regimens are as effective as premixed insulin regimens in people with Type 2 diabetes, with no significant differences in hypoglycaemia and weight gain . It should be noted that the higher costs associated with the intensive blood glucose monitoring needed with a full basal‐bolus regimen may make this option impractical in many countries.…”

Section: Introductionmentioning

confidence: 99%

Review of basal‐plus insulin regimen options for simpler insulin intensification in people with Type 2 diabetes mellitus

Raccah

Huet²,

Dib³

et al. 2017

Diabet. Med.

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AimsTo identify simple insulin regimens for people with Type 2 diabetes mellitus that can be accepted and implemented earlier in primary and specialist care, taking into consideration each individual's needs and capabilities.MethodsUsing randomized clinical trials identified by a search of the PubMed database, as well as systematic reviews, meta‐analyses and proof‐of‐concept studies, this review addresses topics of interest related to the progressive intensification of a basal insulin regimen to a basal‐plus regimen (one basal insulin injection plus stepwise addition of one to three preprandial short‐acting insulin injections/day) vs a basal‐bolus regimen (basal insulin plus three short‐acting insulin injections per day) in people with Type 2 diabetes. The review explores approaches that can be used to define the meal for first prandial injection with basal‐plus regimens, differences among insulin titration algorithms, and the importance of self‐motivation and autonomy in achieving optimum glycaemic control.ResultsA basal‐plus regimen can provide glycaemic control equivalent to that obtained with a full basal‐bolus regimen, with fewer injections of prandial insulin. The first critical step is to optimize basal insulin dosing to reach a fasting glucose concentration of ~6.7 mmol/l; this allows ~40% of patients with baseline HbA1c >75 mmol/mol (9%) to be controlled with only one basal insulin injection per day.ConclusionsCompared with a basal‐bolus regimen, a basal‐plus insulin regimen is as effective but more practical, and has the best chance of acceptance and success in the real world.

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Section: Introductionmentioning

confidence: 99%

Review of basal‐plus insulin regimen options for simpler insulin intensification in people with Type 2 diabetes mellitus

Raccah

Huet²,

Dib³

et al. 2017

Diabet. Med.

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“…There are no reliable cost data for Germany, only estimated calculations based on extrapolations. The annual diabetes-specific direct costs of DM2 were between 542 and 6.323 € per patient, depending on the severity of the diabetes (i. e. the associated secondary complications and the necessary treatments), the study type (i. e. partial calculations based on self-reporting by patients) and the chosen perspective and data sources, respectively 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 . This explains the potentially high costs, especially in the last year of life 34 .…”

Section: Resultsmentioning

confidence: 99%

The Global Threat of Non-Communicable Diseases – Cost and Drivers for Diabetes Type 2 in Germany

Scherdjow

Kiefer

Lüske

et al. 2022

Gesundheitsökonomie & Qualitätsmanagement

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Background Since the last decade, non-communicable diseases, most commonly diabetes mellitus (DM2) have become the main threat to global health. Based on a prevalence of 9 million diabetic patients per year, DM2 constitutes a considerable medical and economic burden in Germany. The healthcare spending and its cost drivers are not yet sufficiently known. Aims of the study The primary objective of this study was to describe the resource use in health care and the cost of DM2 treatment in Germany, focusing on the most significant cost drivers and opportunities for cost-savings. The secondary objective was to analyse the impact of technical progress on diabetes care. Methods A systematic literature search was conducted in PubMed and Embase. Following the PRISMA guidance, the review identified the study design, epidemiological approach, analytical perspective, and data collection approach in each of the included studies. Results From 1.965 records, the final sample included 41 articles. The annual diabetes-specific direct costs of DM2 ranged from 542 € to 6.323 € per patient. The most used method was the incremental or excess cost approach (1.8-fold higher costs compared to individuals without DM2). Intangible costs – such as psychological well-being - were randomly considered in the existing cost-of-illness studies.Confirmed risk factors included physical inactivity, obesity, genetic predispositions, and tobacco use.The major cost drivers are demographic change with aging, increasing obesity, the availability of medications and therapies and the increased use of medical services by patients. Conclusion DM2, based on the results of this study, constitutes a considerable medical and economic burden in Germany and has a serious impact on the government health expenditures.

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“…Higher costs linked to relative weight gain in T2D could partially be explained by increasing HbA 1c levels and consequent initiation of insulin treatment requiring additional healthcare contacts [2,24,25]. As BMI increase is also linked to worsening of cardiovascular risk factors such as blood pressure and cholesterol [2], these patients are also subject to closer monitoring resulting in additional healthcare contacts.…”

Section: Discussionmentioning

confidence: 99%

Weight change patterns and healthcare costs in patients with newly-diagnosed type-2 diabetes in Sweden

Sabale

Bodegård

Svennblad

et al. 2017

Primary Care Diabetes

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Evaluation of insulin initiation on resource utilization and direct costs of treatment over 12 months in patients with type 2 diabetes in Europe: results from INSTIGATE and TREAT observational studies

Abstract: Contributors to total cost differed between countries, potentially reflecting local clinical practice patterns and insulin regimens. In each country, mean direct total costs of T2DM care increased during the first 6 months after insulin initiation and decreased thereafter.

Cited by 7 publications

References 25 publications

Review of basal‐plus insulin regimen options for simpler insulin intensification in people with Type 2 diabetes mellitus

Review of basal‐plus insulin regimen options for simpler insulin intensification in people with Type 2 diabetes mellitus

The Global Threat of Non-Communicable Diseases – Cost and Drivers for Diabetes Type 2 in Germany

Weight change patterns and healthcare costs in patients with newly-diagnosed type-2 diabetes in Sweden

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