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İç Hastalıkları Uzmanları, İnsülin Degludec/Aspart Ko-Formülasyon Tedavisini Nasıl Konumlandırıyor?

Year 2020, Volume: 5 Issue: 1, 11 - 14, 01.04.2020

Abstract

Amaç: İç hastalıkları hekimlerinin insülin degludec/aspart (IDegAsp) tedavisini, hastalar için nerede ve nasıl konumlandırdığının tespitinin yapılması amaçlanmıştır.
Gereç ve Yöntem: Ocak-Aralık 2019 tarihleri arasında yapılan ve hekimlere yöneltilen sorulardan oluşan gözlemsel bir çalışmadır. Hastalar, 18-75 yaş aralığında olup üçüncü basamak bir hastanenin iç hastalıkları polikliniğine başvuranlardan 55 hasta rasgele yöntem ile seçilmişlerdir. Hastalara IDegAsp başlarken hekimlere bu tercihi neden yaptıkları 10 soruluk anket ile sorulmuştur. Sonuçlar sıklıklarına ve hastaların cinsiyetine göre karşılaştırılmıştır
Bulgular: Çalışmaya alınan hastaların 39’u (%71) kadın iken, 16’sı (%29) erkek idi. Tüm hastaların ortanca yaş değeri 62 (23-74) yıl idi. Erkeklerde bu değer 61 (31-73) yıl iken, kadınlarda ise 62 (23-74) yıl idi. Her iki cinsiyetin yaş dağılımları açısından aralarında istatistiksel olarak fark yoktu (p = 0.316). Hastaların 6 tanesi tip 1 diyabetes mellitus iken, 49 tanesinde tip 2 diyabetes mellitus vardı. Tüm hastalar değerlendirildiğinde, IDegAsp başlamak için hekimlerce kabul gören gerekçelerin başında %52.7 ile etkililik gelmektedir. İkinci sırada %40 ile düşük hipoglisemi riski gelirken, üçüncü sırada ise %34.6 ile hasta uyum kolaylığı şeklinde sıralama izlemiştir. Salt erkeklere özgü değerlendirmede ilk üç sıra; %50 hipoglisemi, %43.8 etkililik, %43.8 hasta uyumu şeklinde kaydedilmiştir. Sadece kadınlarda ise; %56.4 etkililik, %35.9 hipoglisemi hesaplanırken üçüncü sırada %30.8 ile hasta uyumu ve doz titrasyon kolaylığı aynı oranda yer almaktadır. Cinsiyetlere göre yapılan karşılaştırmalı istatistiksel değerlendirmelerde anlamlı bir fark saptanmamıştır.
Sonuç: IDegAsp ko-formülasyon tedavisinin etkililik, güvenlilik ve hasta uyumu avantajı hekimlerin tercih sebeplerinin temelini oluşturmaktadır.

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References

  • American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S11–24.
  • Fujimoto K, Iwakura T, Aburaya M, Matsuoka N. Twice-daily insulin degludec/insulin aspart effectively improved morning and evening glucose levels and quality of life in patients previously treated with premixed insulin: an observational study. Diabetol Metab Syndr. 2018 Aug 16;10:64.
  • Seufert J, Borck A, Bramlage P. Addition of a single short-acting insulin bolus to basal insulin-supported oral therapy: a systematic review of data on the basal-plus regimen. BMJ Open Diabetes Res Care. 2019 Oct 1;7(1):e000679.
  • Philis-Tsimikas A, Astamirova K, Gupta Y, Haggag A, Roula D, Bak BA, et al. Similar glycaemic control with less nocturnal hypoglycaemia in a 38-week trial comparing the IDegAsp co-formulation with insulin glargine U100 and insulin aspart in basal insulin-treated subjects with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2019 Jan;147:157-165.
  • Franek E, Haluzík M, Canecki Varžić S, Sargin M, Macura S, Zacho J, Christiansen JS. Twice-daily insulin degludec/insulin aspart provides superior fasting plasma glucose control and a reduced rate of hypoglycaemia compared with biphasic insulin aspart 30 in insulin-naïve adults with Type 2 diabetes. Diabet Med. 2016 Apr;33(4):497-505.
  • Yang W, Ma J, Hong T, Liu M, Miao H, Peng Y, et al. Efficacy and safety of insulin degludec/insulin aspart versus biphasic insulin aspart 30 in Chinese adults with type 2 diabetes: A phase III, open-label, 2:1 randomized, treat-to-target trial. Diabetes Obes Metab. 2019 Jul;21(7):1652-1660.
  • Onishi Y, Ono Y, Rabøl R, Endahl L, Nakamura S. Superior glycaemic control with once-daily insulin degludec/insulin aspart versus insulin glargine in Japanese adults with type 2 diabetes inadequately controlled with oral drugs: a randomized, controlled phase 3 trial. Diabetes Obes Metab. 2013 Sep;15(9):826-32.
  • Gupta S, Wang H, Skolnik N, Tong L, Liebert RM, Lee LK, et al. Treatment Dosing Patterns and Clinical Outcomes for Patients with Type 2 Diabetes Starting or Switching to Treatment with Insulin Glargine (300 Units per Milliliter) in a Real-World Setting: A Retrospective Observational Study. Adv Ther. 2018 Jan;35(1):43-55. doi: 10.1007/s12325-017-0651-3. Epub 2018 Jan 8.

How do Internal Medicine Specialists Position Insulin degludec/aspart Co-formulation Treatment?

Year 2020, Volume: 5 Issue: 1, 11 - 14, 01.04.2020

Abstract

Objective: To determine where and how internal medicine specialists position insulin degludec/aspart (IDegAsp) treatment for patients.
Material and Method: It is an observational study consisting of questions directed to physicians between January and December 2019. The patients were between 18-75 years of age and 55 patients were selected randomly from among those who applied to the internal medicine outpatient clinic of a tertiary hospital. While starting IDegAsp, the patients were asked to the specialists with a questionnaire of 10 questions why they made this preference. The results were compared according to their frequency and gender of the patients.
Results: While 39 (71%) of the patients included in the study were female, 16 (29%) were male. The median age of all patients was 62 (23-74) years. This value was 61 (31-73) years for males and 62 (23-74) years for females. There was no statistical difference between genders in terms of age distribution (p = 0.316). Six of the patients had type 1 diabetes mellitus, while 49 of them had type 2 diabetes mellitus. When all patients are evaluated, efficiency is the most important reason accepted by physicians to start IDegAsp with 52.7%. While the risk of low hypoglycemia was at the second place with 40%, the patient was ranked as ease of compliance with the third place at 34.6%. The first three ranks in the evaluation of men only; 50% hypoglycemia, 43.8% efficiency, 43.8% patient compliance were recorded. Only in women; while calculating 56.4% efficiency and 35.9% hypoglycemia, the third place is 30.8%, patient compliance and ease of dose titration are at the same rate. No significant difference was found in comparative statistical evaluations based on gender.
Conclusion: The effectiveness, safety, and patient compliance advantage of IDegAsp co-formulation therapy is the basis of specialists' preference.

Project Number

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References

  • American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40:S11–24.
  • Fujimoto K, Iwakura T, Aburaya M, Matsuoka N. Twice-daily insulin degludec/insulin aspart effectively improved morning and evening glucose levels and quality of life in patients previously treated with premixed insulin: an observational study. Diabetol Metab Syndr. 2018 Aug 16;10:64.
  • Seufert J, Borck A, Bramlage P. Addition of a single short-acting insulin bolus to basal insulin-supported oral therapy: a systematic review of data on the basal-plus regimen. BMJ Open Diabetes Res Care. 2019 Oct 1;7(1):e000679.
  • Philis-Tsimikas A, Astamirova K, Gupta Y, Haggag A, Roula D, Bak BA, et al. Similar glycaemic control with less nocturnal hypoglycaemia in a 38-week trial comparing the IDegAsp co-formulation with insulin glargine U100 and insulin aspart in basal insulin-treated subjects with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2019 Jan;147:157-165.
  • Franek E, Haluzík M, Canecki Varžić S, Sargin M, Macura S, Zacho J, Christiansen JS. Twice-daily insulin degludec/insulin aspart provides superior fasting plasma glucose control and a reduced rate of hypoglycaemia compared with biphasic insulin aspart 30 in insulin-naïve adults with Type 2 diabetes. Diabet Med. 2016 Apr;33(4):497-505.
  • Yang W, Ma J, Hong T, Liu M, Miao H, Peng Y, et al. Efficacy and safety of insulin degludec/insulin aspart versus biphasic insulin aspart 30 in Chinese adults with type 2 diabetes: A phase III, open-label, 2:1 randomized, treat-to-target trial. Diabetes Obes Metab. 2019 Jul;21(7):1652-1660.
  • Onishi Y, Ono Y, Rabøl R, Endahl L, Nakamura S. Superior glycaemic control with once-daily insulin degludec/insulin aspart versus insulin glargine in Japanese adults with type 2 diabetes inadequately controlled with oral drugs: a randomized, controlled phase 3 trial. Diabetes Obes Metab. 2013 Sep;15(9):826-32.
  • Gupta S, Wang H, Skolnik N, Tong L, Liebert RM, Lee LK, et al. Treatment Dosing Patterns and Clinical Outcomes for Patients with Type 2 Diabetes Starting or Switching to Treatment with Insulin Glargine (300 Units per Milliliter) in a Real-World Setting: A Retrospective Observational Study. Adv Ther. 2018 Jan;35(1):43-55. doi: 10.1007/s12325-017-0651-3. Epub 2018 Jan 8.
There are 8 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Makale
Authors

Hatice Kayış Topaloğlu 0000-0002-8836-7012

Melih Kızıltepe 0000-0001-6100-2024

Mesut Kılıç 0000-0003-0397-4276

Sami Bahçebaşı This is me 0000-0003-0909-7024

Sibel Ata This is me 0000-0003-2935-5684

Şeyma Yıldız This is me 0000-0001-7560-8203

Ulaş Serkan Topaloğlu 0000-0001-6625-7763

Yasin Şimşek 0000-0003-1654-6422

Project Number yok
Publication Date April 1, 2020
Acceptance Date March 20, 2020
Published in Issue Year 2020 Volume: 5 Issue: 1

Cite

Vancouver Kayış Topaloğlu H, Kızıltepe M, Kılıç M, Bahçebaşı S, Ata S, Yıldız Ş, Topaloğlu US, Şimşek Y. İç Hastalıkları Uzmanları, İnsülin Degludec/Aspart Ko-Formülasyon Tedavisini Nasıl Konumlandırıyor?. JAMER. 2020;5(1):11-4.