Achievement of Glycemic Targets when Switching from Basal-Bolus Therapy to V-Go for Insulin Delivery in Type 2 Diabetes

Abstract

Achieving A1C targets is a fundamental component of quality measures such as HEDIS and Star ratings. A typical basal-bolus insulin regimen requires 4 insulin injections a day. Adherence decreases as the number of injections increases and non-adherence to therapy is a primary reason for failure to achieve glycemic control. Less invasive options for insulin delivery may improve patient adherence leading to positive clinical outcomes. This multi-state retrospective analysis evaluated the achievement of glycemic targets compared to prior therapy in 186 patients switched from a basal-bolus regimen to a 24-hour wearable insulin delivery device (V-Go). At baseline, mean A1C was 9.1%, weight 219 lbs and insulin total daily dose (TDD) was 84 u/day across a mean of 4.3 injections/day. Forty-five percent of patients were poorly controlled (A1C > 9%) and less than 30% had achieved an A1C < 8% despite basal-bolus therapy. After 7 months of V-Go use, changes from baseline in A1C and TDD were significant (P<0.0001). Mean change (95% CI) in A1C was -1.02% (-1.24, -0.78) and TDD was reduced by 32% or 25 u/day (31, 19). Weight did not significantly change. Switching to V-Go, resulted in significant improvement to achievement of glycemic targets (90% increase in A1C values < 8% and 50% decrease in A1C values > 9%) compared to prior basal-bolus regimen, having positive implications on quality metrics. Disclosure R.S. Hundal: Speaker's Bureau; Self; Valeritas, Inc., Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca, Novo Nordisk Inc., Amarin Corporation, Eli Lilly and Company, Merck & Co., Inc. S. Kowalyk: Speaker's Bureau; Self; Valeritas, Inc.. J. Cases: None. A. Al-Karadsheh: None. A.P. Wakim: Speaker's Bureau; Self; Versartis, Inc.. Research Support; Self; Valeritas, Inc.. M. Doyle: None. J.H. Sink: Other Relationship; Self; Janssen Pharmaceuticals, Inc., valeritas. Speaker's Bureau; Self; Novo Nordisk Inc.. Consultant; Self; Becton, Dickinson and Company. A. Spence: None. J.L. Brewer: Speaker's Bureau; Self; Valeritas, Inc., Janssen Pharmaceuticals, Inc. C.C. Nikkel: Employee; Self; Valeritas, Inc.. Stock/Shareholder; Self; Valeritas, Inc..