Patient characteristics of insulin lispro 200 units/mL users in real world setting in Germany

Abstract

Objective: Insulin lispro 200 U/mL (IL200) is a treatment choice for people with diabetes who have daily mealtime insulin (MTI) requirements of >20 U/day. We report clinical characteristics of real world IL200 users in Germany to understand clinical settings and the type of patients who would benefit from IL200 treatment. Methods: This retrospective database analysis used the patient-level data from "IMS Disease Analyzer" in Germany from February 2015 to June 2016. Clinical and demographic information were collected and analyzed for IL200 users alongside that of those who were using more than 20 U a day of 100 U/ mL analog MTI. Results: Of the 17,261 patients using insulin, 811 were identified in IL200 group. The IL200 group had 60% men, mean ± SD age of 63.6 ± 11.9 years, and BMI of 36.2 ± 6.7 kg/m 2. Of these, 63.5% (n ¼ 515) were seen by diabetologists, while 36.5% (n ¼ 296) were seen by general practitioners (GPs). In the IL200 group, 77.7% used basal insulin concomitantly, >90% had !1 comorbidity, and 52% had !4 comorbidities; the most common being hypertension (75.2%), neuropathy (66.0%), and nephropathy (59.6%). Diabetologist-treated IL200 users were more likely to have multiple comorbidities as compared with those treated by GPs (15.0% vs. 12.9% for >5 comorbidities). Conclusions: IL200 is prescribed to people with diabetes who need more than 20 U/day of mealtime insulin and tend to be more obese, older, and with multiple comorbidities. Future research should explore how concentrated MTI can impact adherence and long-term glycemia.

Profile of Patients with Diabetes Treated with Insulin Lispro 200 U/ml: A Real-World Study from Spain

“…It showed that patients with T1D and T2D who were prescribed IL200 generally presented with poor glycemic control, a high BMI, and diabetes-associated comorbidities and were receiving high doses of insulin at IL200 initiation. This patient profile is aligned with previous observational studies of IL200 in other European countries [ 12 , 13 ].…”

“…The largest age group of patients was 18–39 years for those with T1D and 60–69 years for those with T2D. Patients with T1D cannot be compared with other real-world studies of patients receiving IL200, as these mostly or only comprised patients with T2D [ 12 , 13 ].…”

“…Evidence on the use of IL200 in real-world practice conditions in the post-marketing setting is sparse. A retrospective database analysis of patients in Germany revealed that, as per the summary of product characteristics [ 7 ], IL200 is prescribed mainly to people with diabetes who need > 20 U/day of mealtime insulin and that these patients are often older and have obesity and multiple comorbidities [ 12 ]. Similarly, a study of a small group of patients with T2D in the UK showed that IL200 users comprised mainly older patients with diabetes complications and poor glycemic control [ 13 ].…”

Satisfaction, Preference and Injection Habits of Switching to 200 Units/ml Insulin Lispro Pen from 100 Units/ml: A Patient Survey in Germany

“…Finally, there was a lack of representation of T1DM, younger patients and non-obese patients, therefore concluding IL200 satisfaction and preferences for these groups are limited. However, our sample characteristics match closely to a recent retrospective cohort study of 811 IL200 users [15] which may lend confidence to the generalizability of our study and explain the underrepresentation of certain groups in our sample.…”

“…No evidence was found to suggest that any other demographic or clinical characteristic was associated with higher or lower satisfaction for IL200. It is possible that many physicians tend to prescribe IL200 to patients who are obese [15] because of higher insulin requirements of obese patients; however, our study did not support this in terms of differences in patient satisfaction for IL200 for different BMI groups.…”