Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
06
2018
accepted:
08
08
2019
entrez:
29
8
2019
pubmed:
29
8
2019
medline:
4
3
2020
Statut:
epublish
Résumé
Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology. In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling. There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels. Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.
Sections du résumé
BACKGROUND
Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology.
METHODS
In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling.
RESULTS
There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels.
CONCLUSION
Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.
Identifiants
pubmed: 31461470
doi: 10.1371/journal.pone.0221462
pii: PONE-D-18-19449
pmc: PMC6713357
doi:
Substances chimiques
Insulin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0221462Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Clin Ther. 2003 Nov;25(11):2836-48
pubmed: 14693308
Clin Ther. 2006 Oct;28(10):1712-25; discussion 1710-1
pubmed: 17157128
Pharmacotherapy. 2007 Jul;27(7):948-62
pubmed: 17594200
J Diabetes Sci Technol. 2011 Sep 01;5(5):1116-23
pubmed: 22027304
PLoS One. 2011;6(10):e26864
pubmed: 22066013
Diabetes Technol Ther. 2013 Sep;15(9):776-85
pubmed: 23786228
J Med Econ. 2013 Oct;16(10):1231-7
pubmed: 23834480
Curr Med Res Opin. 2013 Oct;29(10):1287-96
pubmed: 23865725
J Med Econ. 2013 Oct;16(10):1228-30
pubmed: 23926888
Diabetes Care. 2014;37(1):9-16
pubmed: 24356592
Clin Ther. 2014 Jul 1;36(7):1043-53
pubmed: 24913030
Curr Med Res Opin. 2015 May;31(5):891-9
pubmed: 25710707
Patient Prefer Adherence. 2015 Mar 27;9:517-28
pubmed: 25848231
Int J Clin Pract. 2015 Oct;69(10):1050-70
pubmed: 26147376
Hosp Pharm. 2015 Jun;50(6):514-21
pubmed: 26405343
Adv Ther. 2015 Dec;32(12):1206-21
pubmed: 26563324
J Diabetes Sci Technol. 2016 Jun 28;10(4):959-66
pubmed: 26920639
JAMA. 2016 Apr 5;315(13):1400-2
pubmed: 27046369
Expert Opin Pharmacother. 2017 Feb;18(3):233-234
pubmed: 28067057
Lancet Diabetes Endocrinol. 2017 Jun;5(6):431-437
pubmed: 28365411
BMJ Glob Health. 2016 Oct 12;1(3):e000112
pubmed: 28588966
Lancet. 2017 Sep 16;390(10100):1260-1344
pubmed: 28919118
Arch Iran Med. 2017 Sep;20(9):608-616
pubmed: 29048923
JAMA. 2017 Nov 14;318(18):1825-1827
pubmed: 29136434
Int Health. 2018 May 1;10(3):182-190
pubmed: 29617832
Eur Endocrinol. 2018 Apr;14(1):47-51
pubmed: 29922352
Med J Islam Repub Iran. 2018 May 12;32:39
pubmed: 30159290
Med J Islam Repub Iran. 2018 Oct 20;32:102
pubmed: 30854346
Clin Chem. 1972 Jun;18(6):499-502
pubmed: 4337382