Initiation of insulin glargine in patients with Type 2 diabetes in suboptimal glycaemic control positively impacts health‐related quality of life. A prospective cohort study in primary care

Hajos, Tibor; Pouwer, Frans; Grooth, R. de; Holleman, F.; Twisk, Jos W. R.; Diamant, Michaëla; Snoek, Frank J.

doi:10.1111/j.1464-5491.2011.03329.x

Cited by 35 publications

(46 citation statements)

References 28 publications

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“…Similar results were obtained in a Chinese observational study evaluating the effect of initiation of biphasic insulin aspart 30 in 6,612 insulin naïve patients, or switching to this insulin analogue in 1,966 already insulin-treated subjects [21]. In a Dutch prospective cohort study, initiation of insulin glargine in both insulin-naïve as well as in insulin-treated patients with type 2 diabetes, resulted in improvement in QoL [22]. However, in a prospective, multicentre, randomized, open label, crossover study conducted in Holland, no differences were found between patients initiating insulin glargine and insulin NPH regarding QoL [23].…”

Section: Discussionsupporting

confidence: 66%

Association between insulin therapy and quality of life in diabetes

Dąbrowski¹,

Filip²,

Huc³

2017

J Pre Clin Clin Res.

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Introduction. Diabetes is associated with a lower quality of life (QoL). Insulin therapy is perceived as an additional factor affecting QoL. The objective of this study, using standardized tools, was to evaluate to what extent insulin treatment has an effect on QoL in diabetes. Materials and method. 60 diabetic patients treated with insulin and 90 with oral drugs, all aged over 30, were included into the study. To assess the QoL of patients, SF-36 v.2 and WHOQOL-BREF questionnaires were used. In addition, demographic data were collected. Results. Insulin treated patients had a significantly lower Mental Component Score in SF-36 v.2 questionnaire. No significant differences between the two groups were found in the components of physical domain of SF-36 v.2 and in four domains of WHOQOL-BREF questionnaires. Insulin therapy was significantly associated with lower educational level. The strongest association with QoL in both questionnaires was found for professional activity and age. Conclusions. The results of this study indicate the need for psychological support for patients with diabetes treated with insulin to improve their mental coping. Diabetic patients should also be advised to continue their professional activity for as long as possible due to its important role in maintaining QoL.

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Section: Discussionsupporting

confidence: 66%

Association between insulin therapy and quality of life in diabetes

Dąbrowski¹,

Filip²,

Huc³

2017

J Pre Clin Clin Res.

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“…Patients were invited to participate in the SPIRIT and ESPRIT studies by their primary or secondary care treating physician if there was a clinical necessity to initiate long-acting insulin. Both studies are described in more detail elsewhere (14,15). The present analyses used only baseline data collected before insulin initiation or intensification.…”

Section: Methodsmentioning

confidence: 99%

Toward Defining a Cutoff Score for Elevated Fear of Hypoglycemia on the Hypoglycemia Fear Survey Worry Subscale in Patients With Type 2 Diabetes

Hajos¹,

Polonsky²,

Pouwer

et al. 2013

Diabetes Care

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OBJECTIVETo determine a cutoff score for clinically meaningful fear of hypoglycemia (FoH) on the Hypoglycemia Fear Survey Worry subscale (HFS-W). RESEARCH DESIGN AND METHODSData on the HFS-W, history of hypoglycemia, emotional well-being (World Health Organization-5 well-being index), and distress about diabetes symptoms (Diabetes Symptom Checklist-Revised) were available from Dutch patients with type 2 diabetes who were treated with oral medication or insulin (n = 1,530). Four criteria were applied to define a threshold for clinically meaningful FoH: 1) modal score distribution (MD criterion), 2) scores 2 SDs above the mean (SD criterion), 3) concurrent validity with severe hypoglycemia and suboptimal well-being (CV criterion), and 4) an elevated score ( ‡3) on more than one HFS-W item (elevated item endorsement [EI criterion]). Associations between the outcomes of these approaches and a history of severe hypoglycemia and suboptimal well-being were studied. RESULTSOf the 1,530 patients, 19% had a HFS-W score of 0 (MD criterion), and 5% reported elevated FoH (HFS-W ‡ mean 1 2 SD; SD criterion). Patients with severe hypoglycemia reported higher HFS-W scores than those without (25 6 20 vs. 15 6 17; P < 0.001). Patients with suboptimal well-being reported higher HFS-W scores than those with satisfactory well-being (20 6 18 vs. 13 6 15; P < 0.001, CV criterion). Elevated FoH (defined by the EI criterion) was seen in 26% of patients. The SD and EI criteria were the strongest associated with history of severe hypoglycemia. The EI criterion was the strongest associated with suboptimal well-being. CONCLUSIONSAlthough no definite cutoff score has been determined, the EI criterion may be most indicative of clinically relevant FoH in this exploratory study. Further testing of the clinical relevance of this criterion is needed.

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“…The HPR specializes in the development and use of Patient-Reported Outcome measures in diabetes research and have been used in previous studies that accessed TS and QoL. 7,8 A licence agreement before using the questionnaires was obtained by the study sponsor.…”

Section: Assessment Of Diabetes Dependent Quality Of Life and Diabetementioning

confidence: 99%

“…6 Several clinical trials demonstrated efficacy of insulin treatment in insulin-naïve patients and favourable effects on HRQoL. 5,7,8 However, for patients with T2DM starting a long-acting insulin as an add-on treatment on OADs in Greece, data on the effect on QoL indices are limited or poorly documented.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life of Insulin-Naïve People with Type 2 Diabetes Mellitus Inadequately Controlled on Oral Antidiabetic Drugs after the Addition of Insulin Glargine, in Every Day Clinical Practice in Greece

Koukoulis¹

2015

JDMDC

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Abbreviations: T2DM, type 2 diabetes mellitus; OADs, oral antdiabetic drugs; ADDQoL, audit of diabetes dependent quality of life; DTSQs/c, diabetes treatment satisfaction questionnaire status/ change; QoL, quality of life; TS, treatment satisfaction IntroductionQuality of Life (QoL) is quantitated by assessing physical and social functioning and perceived physical and mental well-being. It is an important health outcome in its own right, representing the ultimate goal of all health interventions. QoL is of particular concern to those patients with chronic diseases. Type 2 diabetes mellitus (T2DM) is a chronic disease and is associated with short-term and long-term complications which can negatively affect patients' well-being, health status and QoL. Compared to persons without diabetes, most studies reported worse QoL for people with diabetes, especially regarding physical functioning and wellbeing. 1,2Diabetes places a significant burden upon health related quality of life (HRQoL), with patients experiencing a reduction in both total and health life years as a result of disability and related comorbidities. Additional challenges arise during the management of diabetes, where the fear of hypoglycaemia, fear of insulin injections and complex treatment regimens are major concerns among patients and have an impact on QoL. The relationship between QoL and diabetes is bidirectional; aspects of diabetes may negatively impact QoL and impaired QoL may also negatively influence diabetes self-management and thus health outcomes and treatment satisfaction (TS).3 Diabetes therapy such as receiving insulin has the potential to affect QoL in both negative and positive ways. Clearly, QoL can be impeded by concerns about needles/pain, hassles of frequent injections, fears and episodes of hypoglycaemia, weight gain, and other potential adverse events. On the other hand, improved glycaemic control can have positive ramifications and also reduce diabetic complications. AbstractObjectives: To assess the quality of life (QoL) of insulin-naïve people with Type 2 Diabetes Mellitus (T2DM) inadequately controlled on oral antidiabetic drugs (OADs)) after the addition of insulin glargine through the use of self-reported questionnaires (ADDQoL, DTSQs and DTSQc).Design: Insulin-naïve Greek patients with T2DM >1 year inadequately controlled on at least 2 OADs as assessed by HbA1c between 7.0%-9.0% were recruited. The addition of insulin glargine to the treatment was initiated within one month prior to enrollment and patients were evaluated at the beginning of the study and at 3 and 6months through HbA1c measurements and self-reported quality of life questionnaires. Data were analyzed using descriptive statistics.Results: HbA1c (%) ±SD decreased from 8.3±0.5to 7.4±0.7and 7.2±0.6at 3 and 6months, respectively (p<0.001). No significant changes in symptomatic hypoglycemia and no severe hypoglycemia were reported. Concerning the ADDQoL-19, the "present" QoL score improved from 0.42± 0.97 to 0.79±0.81 and 0.93± 0.82 (p<0.001), the "If no Diabete...

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Initiation of insulin glargine in patients with Type 2 diabetes in suboptimal glycaemic control positively impacts health‐related quality of life. A prospective cohort study in primary care

Abstract: Results of this observational study demonstrate combined glycaemic and health-related quality of life benefits of initiating insulin glargine in patients with Type 2 diabetes in routine primary care.

Cited by 35 publications

References 28 publications

Association between insulin therapy and quality of life in diabetes

Association between insulin therapy and quality of life in diabetes

Toward Defining a Cutoff Score for Elevated Fear of Hypoglycemia on the Hypoglycemia Fear Survey Worry Subscale in Patients With Type 2 Diabetes

Quality of Life of Insulin-Naïve People with Type 2 Diabetes Mellitus Inadequately Controlled on Oral Antidiabetic Drugs after the Addition of Insulin Glargine, in Every Day Clinical Practice in Greece

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