Abstract
PurposeFive quality of life (QoL) domains are particularly important to patients with type 2 diabetes (T2D) using basal insulin—sense of physical well-being, sense of safety regarding hypoglycemia, sense of diabetes as burdensome, feelings of freedom and flexibility, and sleep quality.MethodsAn online survey assessed these QoL domains in adult patients with T2D in the USA who had switched from a previous basal insulin to insulin degludec (IDeg): modified versions of the World Health Organization (Five) Well-Being Index (WHO-5), Hypoglycemia Attitudes and Behavior Scale (HABS; confidence and anxiety subscales only), and Diabetes Distress Scale (DDS; emotional burden and regimen-related distress subscales only); three items assessing feelings of freedom and flexibility; and one item assessing sleep quality (hours of restful sleep). Patients rated each item for their previous basal insulin and currently while using IDeg. Correlations between sleep quality and the other QoL scales were also assessed.ResultsIn total, 152 patients completed the survey and were included in the study sample. Patients reported significantly improved scores while using IDeg on all WHO-5, DDS, HABS, feelings of freedom and flexibility item scores, and total raw/mean subscale scores (P < 0.0001). Patients also reported a significantly greater number of hours of restful sleep [mean (SD) 6.6 (2.0) vs. 5.5 (1.8); P < 0.0001]. Better sleep quality statistically significantly correlated with improved QoL in all other domains assessed.ConclusionsTreatment with IDeg after switching from a previous basal insulin was associated with statistically significant improvements in all QoL domains assessed.
Highlights
The addition of basal insulin is a well-established approach in patients with type 2 diabetes (T2D) who require intensification of antihyperglycemic therapy [1, 2]
Studies of the blood glucose-lowering effect of Insulin degludec (IDeg) have shown that IDeg has a flatter, more stable pharmacodynamic profile compared with insulin glargine U-100 and U-300 [5, 6]
The primary aim of this study was to examine the impact between quality of life (QoL) scores with switching from previous basal insulin use to the use of IDeg, and if this was affected by the nature of the reason for switching, i.e., if it was primarily due to lack of health insurance coverage for the previous insulin
Summary
The addition of basal insulin is a well-established approach in patients with type 2 diabetes (T2D) who require intensification of antihyperglycemic therapy [1, 2]. Insulin degludec (IDeg) is one of several second-generation long-acting insulin analogs approved in the USA to improve glycemic control in patients with diabetes mellitus, available in the USA as of January 2016 [3, 4]. Randomized controlled trials have found that IDeg is associated with significantly lower rates of severe hypoglycemia and nocturnal hypoglycemia than is insulin glargine U-100 in patients with T2D while. Success of antihyperglycemic treatments in real-world clinical practice is determined by their clinical effectiveness and safety profile, and by a range of additional factors that may affect treatment satisfaction and, adherence [10]. To obtain a comprehensive understanding of the potential value of a diabetes intervention, it is important to evaluate treatment outcomes in the broader context of treatment-related factors that may impact quality of life (QoL) [10]
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