Perspectives and Preferences of People with Type 2 Diabetes for the Attributes of Weekly Insulin.

IF 3.8 3区 医学 Q2 Medicine Diabetes Therapy Pub Date : 2024-11-01 Epub Date: 2024-09-30 DOI:10.1007/s13300-024-01652-0
Felicia T Gelsey, David Schapiro, Katherine Kosa, Caroline Vass, Magaly Perez-Nieves, Anna Pierce, Jiat Ling Poon, Dana DiBenedetti, Carol Mansfield
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Abstract

Introduction: Daily insulin administration can be burdensome for people with type 2 diabetes (PwT2D) and can impact treatment adherence. This study investigated preferences for once-weekly, long-acting basal insulin for treatment of PwT2D.

Methods: An online discrete-choice experiment was administered to PwT2D in the USA. Qualitative interviews informed the selection of six attributes: reduction in A1c level after 6 months, amount of time spent in optimal blood sugar range each day, number of serious low blood sugar events, number of nighttime low blood sugar events, change in weight because of the insulin over 6 months, and frequency of administration. Each participant completed eight questions offering a choice between two long-acting insulins; questions varied according to an experimental design. A fixed treatment choice question asked about preferences for daily versus weekly insulin, holding other treatment features constant. Data were analyzed using random-parameters logit models, and heterogeneity was explored through subgroup analyses.

Results: Four hundred sixty-six PwT2D completed the survey (mean age, 57; mean A1c, 7.5%; 59.0% female); 33.3% of these were currently on a basal/bolus regimen, 34.3% used basal only, and 32.4% were insulin naive. Respondents placed the most importance on avoiding a 10-pound weight change and equal importance on the largest change in the number of serious and nighttime low blood sugar events per year and achieving the longest time in range included in the choice questions. There was significant heterogeneity in preferences by experience: insulin-naive respondents had stronger preferences for scheduled and flexible weekly insulin over daily insulin; 67.6% preferred flexible weekly over daily insulin, all else being equal.

Conclusion: PwT2D valued insulin efficacy and reducing treatment-related adverse events, with heterogeneity in the relative importance of administration frequency. All else being equal, respondents preferred weekly over daily basal insulin. These findings provide insights into the preferences of PwT2D considering weekly long-acting insulin.

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2 型糖尿病患者对每周胰岛素属性的看法和偏好。
导言:对于 2 型糖尿病患者(PwT2D)来说,每天注射胰岛素是一项负担,而且会影响治疗的依从性。本研究调查了 2 型糖尿病患者对一周一次的长效基础胰岛素治疗的偏好:方法:对美国的 PwT2D 患者进行了在线离散选择实验。定性访谈为选择以下六个属性提供了依据:6 个月后 A1c 水平的降低、每天在最佳血糖范围内停留的时间、严重低血糖事件的次数、夜间低血糖事件的次数、6 个月内使用胰岛素后体重的变化以及用药频率。每位受试者都要回答 8 个问题,在两种长效胰岛素中做出选择;问题根据实验设计而有所不同。在其他治疗特征保持不变的情况下,一个固定的治疗选择问题询问的是对每日胰岛素和每周胰岛素的偏好。采用随机参数 logit 模型对数据进行了分析,并通过亚组分析探讨了异质性:466 名糖尿病患者完成了调查(平均年龄为 57 岁;平均 A1c 为 7.5%;59.0% 为女性);其中 33.3% 的患者目前正在使用基础胰岛素/鹅口疮胰岛素治疗方案,34.3% 的患者仅使用基础胰岛素,32.4% 的患者为胰岛素初学者。受访者最重视的是避免体重变化 10 磅,同样重视的是每年严重低血糖和夜间低血糖事件次数的最大变化,以及在选择问题中达到最长时间的范围。不同经验的受访者对胰岛素的偏好存在明显差异:未使用过胰岛素的受访者更偏好按时和每周灵活使用胰岛素,而非每日使用胰岛素;在其他条件相同的情况下,67.6%的受访者更偏好每周灵活使用胰岛素,而非每日使用胰岛素:结论:2 岁以下儿童重视胰岛素的疗效和减少与治疗相关的不良反应,而给药频率的相对重要性则不尽相同。在其他条件相同的情况下,受访者更倾向于每周使用基础胰岛素,而非每天使用。这些研究结果让我们了解了考虑每周使用长效胰岛素的二病患者的偏好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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