Management of adult patients with type 1 diabetes mellitus in Africa

Mbanya, Jean Claude; Naidoo, Poobalan; Kolawole, Babatope; Цымбал, Е В; McMaster, Alicia; Karamchand, Sumanth; Kaplan, Hilton M.; Rambiritch, Virendra; Cotton, Mark F.; Malek, R.; Distiller, L. A.; Leisegang, Rory

doi:10.1097/md.0000000000020553

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…Также был отмечен более высокий уровень HbA 1c у пользователей инъекций по сравнению с пользователями помпы в возрастной группе от 30 до <50 лет. В странах Африки в тот же период времени HbA 1c был ниже 7% у 16,6% [19,20].…”

Section: Minimedunclassified

Pharmacoepidemiological analysis of type 1 diabetes mellitus insulin therapy (According to the Moscow segment of the State Register of Diabetes Mellitus)

Antsiferov,

Kantemirova,

Demidov

et al. 2023

Diabetes mellitus

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BACKGROUND: When developing programs for state reimbursement of the cost of medical services and medicines, when providing assistance to patients suffering from type 1 diabetes mellitus (DM1), data based on the results of pharmacoepide-miological studies (FEI) conducted in real clinical practice of treating patients are needed. The obtained results of the analysis of drug consumption allow us to study the most commonly used insulin therapy regimens and their compliance with modern clinical recommendations. Calculations of the weighted average cost of conducting hypoglycemic therapy in DM1 can be used for further pharmacoeconomical calculations, including analysis of the medical and social cost of the disease.AIM: To conduct a pharmacoepidemiological analysis of the consumption of insulin preparations according to the ATX /DDD methodology, to study the modes of insulin administration and the ratio of the weighted average cost of insulin therapy components per 1 patient with DM1 per year in the outpatient practice of treatment with the introduction of insulin in the mode of multiple injections of insulin (MII) and during continuous subcutaneous insulin infusion (CSII).MATERIALS AND METHODS: A retrospective continuous cohort analytical pharmacoepidemiological study was conducted on the basis of the SRDM database (status as of 01/01/2020), in which 17,617 patients with T1DM aged 18 years and older were registered at the time of the study.RESULTS: 90% of patients received analogues of human insulin in the MII mode using syringe pens, 8.6% used the CSII mode. In 34.5% of patients with DM1 HbA1c was <7%, the proportion of patients with HbA1c >8% was 28%. The average cost of insulin therapy per 1 person per year was 54,977 rubles. The cost of basal insulin treatment per 1 patient per year was approximately 1.5 times higher than the cost of bolus insulin during insulin therapy in the MII mode (33,960 rubles and 21,017 rubles, respectively). The weighted average cost of insulin per 1 patient per year for CSII was 31,822 rubles.CONCLUSION: The majority of patients with DM1 in the study cohort received analogues of human insulin in the basic bolus mode of MII using syringe pens, which corresponds to existing clinical recommendations. The proportion of patients achieving the goals of glycemic control is comparable to the data obtained on the basis of registers of diabetic patients in other economically developed countries

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Section: Minimedunclassified

Pharmacoepidemiological analysis of type 1 diabetes mellitus insulin therapy (According to the Moscow segment of the State Register of Diabetes Mellitus)

Antsiferov,

Kantemirova,

Demidov

et al. 2023

Diabetes mellitus

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“…The financial burden associated with the management of this disease is significant and estimated to cost South Africa in excess of R27.9 billion per annum. (2,3) Early diagnosis and intervention can improve morbidity and mortality, but in the South African healthcare setting, T1DM is not always managed optimally with less than 17% of patients obtaining the target glycosylated haemaglobin (HbA1c) of <7%. (2,4) Failure to obtain glycaemic control is associated with an increase in micro-and macrovascular complications.…”

Section: Introductionmentioning

confidence: 99%

“…(2,3) Early diagnosis and intervention can improve morbidity and mortality, but in the South African healthcare setting, T1DM is not always managed optimally with less than 17% of patients obtaining the target glycosylated haemaglobin (HbA1c) of <7%. (2,4) Failure to obtain glycaemic control is associated with an increase in micro-and macrovascular complications. In patients with T1DM in South Africa, a 20-year mortality of 43% has been noted, which can be attributed to renal failure, hypoglycaemia and ketoacidosis, all of which are linked to poor glycaemic control.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Glycaemic Control in Adults Living with Type 1 Diabetes: A 1-Year Retrospective Chart Review at Two South African Public Sector Tertiary Hospitals

Poobalan,

Bruno,

Ebrahim

et al. 2023

Wits Journal of Clinical Medicine

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Background: An estimated 11.8% of the South African population are living with diabetes. There is a paucity of data related to the clinical characteristics and glycaemic control in people living with T1DM within the South African public healthcare sector. Objective: To describe the clinical characteristics and glycaemic control of people living with T1DM in a public health care setting. Methods: The study was an observational study conducted at two tertiary public sector hospitals in South Africa by means of a chart review. The study involved adults living with T1DM treated with human insulin for 12 months prior to the date of informed consent. Results: A total of 224 patients with T1DM were enrolled, with 190 (84.8%) from Chris Hani Baragwanath Academic Hospital and 34 (15.2%) from Klerksdorp Tshepong Hospital Complex. One patient withdrew consent, leaving a total analysed population of 223. Of the 223 patients, 37 (16.6%) were controlled (most recent glycosylated haemoglobin (HbA1c) < 7%) while the remainder 186 (83.4%) were uncontrolled (most recent HbA1c ≥ 7%). The mean age of the study group was 33 ± 9 years. The majority of participants were female (122 [54.7%]) and of black ethnicity (215 [96.4%]). The mean number of hypoglycaemic events per patient-year was 151.4 (SD ± 213.9). Diabetic ketoacidosis occurred more frequently in the uncontrolled group. Conclusion: The majority of patients in this study did not achieve target HbA1c, placing them at higher risk for long-term diabetes complications. Poor glycaemic control, leading to long term complications, as well as hypoglycaemia and diabetic ketoacidosis adds further strain to the resource constrained public healthcare in South Africa.

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A century past the discovery of insulin: global progress and challenges for type 1 diabetes among children and adolescents in low-income and middle-income countries

Bhutta

Salam²,

Gomber

et al. 2021

The Lancet

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Management of adult patients with type 1 diabetes mellitus in Africa

Cited by 6 publications

References 18 publications

Pharmacoepidemiological analysis of type 1 diabetes mellitus insulin therapy (According to the Moscow segment of the State Register of Diabetes Mellitus)

Pharmacoepidemiological analysis of type 1 diabetes mellitus insulin therapy (According to the Moscow segment of the State Register of Diabetes Mellitus)

Clinical Characteristics and Glycaemic Control in Adults Living with Type 1 Diabetes: A 1-Year Retrospective Chart Review at Two South African Public Sector Tertiary Hospitals

A century past the discovery of insulin: global progress and challenges for type 1 diabetes among children and adolescents in low-income and middle-income countries

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