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Improvements in quality of life associated with insulin analogue therapies in people with type 2 diabetes: Results from the A1chieve observational study

Siddharth Shah, Alexey Zilov, Rachid Malek, Pradana Soewondo, Ole Bech and Leon Litwak

Diabetes Research and Clinical Practice, Issue 3, Volume 94, pages 364 - 370

Received 20 September 2011, Revised 10 October 2011, Accepted 13 October 2011, Published online Nov-2011


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1. Introduction

It is widely recognised that having type 2 diabetes (T2DM) has a negative impact on quality of life (QoL) [1] x R.R. Rubin, M. Peyrot. Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15(3):205-218 . Having to deal with lifestyle change, complex treatment regimens, potentially having to manage self-injection, and sometimes fear of hypoglycaemia and weight gain can contribute to poor QoL and adverse perceptions of diabetes therapies [2], [3], and [4] x M. Peyrot, R.R. Rubin, K. Khunti. Addressing barriers to initiation of insulin in patients with type 2 diabetes. Primary Care Diabetes. 2010;4(Suppl. 1):S11-S18 x C.J. Currie, C.L. Morgan, C.D. Poole, P. Sharplin, M. Lammert, P. McEwan. Multivariate models of health-related utility and the fear of hypoglycaemia in people with diabetes. Curr Med Res Opin. 2006;22:1523-1534 x S.A. Brunton, S.N. Davis, S.M. Renda. Overcoming psychological barriers to insulin use in type 2 diabetes. Clin Cornerstone. 2006;8(Suppl. 2):S19-S26 . Consequently, people with T2DM and their physicians often delay starting or optimizing insulin therapy, despite the current burdens of poor glycaemic control [4], [5], [6], and [7] x S.A. Brunton, S.N. Davis, S.M. Renda. Overcoming psychological barriers to insulin use in type 2 diabetes. Clin Cornerstone. 2006;8(Suppl. 2):S19-S26 x W.H. Polonsky, L. Fisher, S. Guzman, L. Villa-Caballero, S.V. Edelman. Psychological insulin resistance in patients with type 2 diabetes: the scope of the problem. Diabetes Care. 2005;28:2543-2545 x D.G. Marrero. Overcoming patient barriers to initiating insulin therapy in type 2 diabetes mellitus. Clin Cornerstone. 2007;8(2):33-40 x M.J. Calvert, R.J. McManus, N. Freemantle. Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: retrospective cohort study. Br J Gen Pract. 2007;57(539):455-460 . Alongside effective glycaemic control, maintaining or improving QoL is an integral part of the successful management of diabetes. Indeed, it is known that measured QoL improves with better glycaemic control [8] x A.M. Jacobson. Impact of improved glycemic control on quality of life in patients with diabetes. Endocr Pract. 2004;10(6):502-508 .

Literature reporting the effect of insulin analogues on QoL is scarce, with one recent systematic review investigating basal insulin analogues being unable to identify any suitable trials measuring QoL in people with T2DM [9] x N. Waugh, E. Cummins, P. Royle, C. Clar, M. Marien, B. Richter, et al. Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation. Health Technol Assess. 2010;14(36):1-248 .

As the largest observational study ever conducted in insulin therapy, and with a broad geographical base, the A1chieve study evaluated the safety and effectiveness of starting insulin with, or switching to, insulin analogue-based regimens in a large and diverse population from a wide variety of clinical environments [10] x S.N. Shah, L. Litwak, J. Haddad, P.N. Chakkarwar, I. Hajjaji. The A1chieve study: a 60 000-person, global, prospective, observational study of basal, meal-time, and biphasic insulin analogs in daily clinical practice. Diabetes Res Clin Pract. 2010;88(Suppl. 1):S11-S16 . It is then well placed to investigate health-related quality of life (HRQoL). The aim of the current analysis was to determine the effects on HRQoL of insulin analogue therapies in people with T2DM.

References

Label Authors Title Source Year
[1]

References in context

  • It is widely recognised that having type 2 diabetes (T2DM) has a negative impact on quality of life (QoL) [1].
    Go to context

R.R. Rubin, M. Peyrot Quality of life and diabetes Diabetes Metab Res Rev. 1999;15(3):205-218 1999
[8]

References in context

  • Indeed, it is known that measured QoL improves with better glycaemic control [8].
    Go to context

  • In A1chieve, QoL significantly improved for people irrespective of prior insulin status, and it is known that improvements in glycaemic control are associated with improvements in QoL [8].
    Go to context

A.M. Jacobson Impact of improved glycemic control on quality of life in patients with diabetes Endocr Pract. 2004;10(6):502-508 2004
[9]

References in context

  • Literature reporting the effect of insulin analogues on QoL is scarce, with one recent systematic review investigating basal insulin analogues being unable to identify any suitable trials measuring QoL in people with T2DM [9].
    Go to context

N. Waugh, E. Cummins, P. Royle, C. Clar, M. Marien, B. Richter, et al. Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation Health Technol Assess. 2010;14(36):1-248 2010
[10]

References in context

  • As the largest observational study ever conducted in insulin therapy, and with a broad geographical base, the A1chieve study evaluated the safety and effectiveness of starting insulin with, or switching to, insulin analogue-based regimens in a large and diverse population from a wide variety of clinical environments [10].
    Go to context

S.N. Shah, L. Litwak, J. Haddad, P.N. Chakkarwar, I. Hajjaji The A1chieve study: a 60 000-person, global, prospective, observational study of basal, meal-time, and biphasic insulin analogs in daily clinical practice Diabetes Res Clin Pract. 2010;88(Suppl. 1):S11-S16 2010

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