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Type 2 Diabetes Treatment, what about insulin analogy transformed in insulin?


According to a large -scale retrospective queue research published on JAMA, type 2 diabetic patients treated with insulin categories to human insulin can reduce expenses without causing harm.

Researchers analyzed the blood glucose control and cost differences of participants in the health plan intervention measures in 2014, 2015 and 2016. Participants were encouraged to convert insulin therapy from insulin analogs to human insulin. In general, participants have a small increase in the statistical (but may not be clinically), and the incidence of severe hypoglycemia or hyperglycemia is not different. At the same time, the spending of the participants dropped sharply.

Researchers emphasized that these discoveries should prompt doctors and patients to re -consider which insulin is most suitable. Human insulin may not be the best choice for everyone. Some patients may not be able to convert them to human insulin, including patients with 1 diabetes or increased risk of hypoglycemia. But it may be one of the important choices for many diabetic patients.

It has little effect on blood sugar control

Researchers analyzed data from 14,635 participants including California, Arizona, Nevada and Virginia. These participants completed a total of 221866 insulin prescriptions from 2014-2016.

From February to June 2015, researchers have carried out a treatment plan to encourage participants from high-cost insulin analogs to low-cost insulin (pre-mixed insulin 70/30 or NPH insulin). The plan is supported by pharmacists, nurses, physicians, and physicians with chronic disease management experience. Participants have an average age of 72.5 years, 51%are women, and 93.1%are patients with type 2 diabetes.

The proportion of insulin prescriptions for insulin analogs dropped from 89%at the baseline to 30%after intervention, and the proportion of human insulin prescriptions increased from 11%to 70%. From the perspective of the average HBA1C of 8.46%at the baseline, intervention began to increase with the participant HBA1C 0.14%(P = 0.003) and 0.02 percentage points (P <0.001) at 0.02 percentage points per month. However, at the end of the year after the intervention, the changes of the participants HBA1C and the monthly slope change were significantly different from the baseline value (P = 0.09 and P = 0.81).

During the entire study, the incidence of severe hypoglycemia or high blood sugar was not significantly different.

A significant reduction

In general, insulin expenditure decreased by more than 50%, from about $ 3.4 million in December 2014 to $ 1.4 million/month in December 2016. Although the monthly insulin analog expenditure increased from US $ 2226389 in January 2014 to December 321,4437 US dollars, in December 2016, the cost of insulin analogs had fallen to $ 51,5875. At the same time, human insulin expenditure increased from $ 160,233 in January 2014 to $ 916,286 in December 2016.

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Researchers said that a bottle of 1000U NPH or conventional insulin can be purchased at a price of $ 25, and the retail price of a bottle of insulin analogs is between $ 178 and $ 320. It is difficult to imagine that consumers in almost any other environment are willing to pay such a huge price difference, without evidence that they will benefit from it.

Medical pulse compilation and compilation from: Switching to Human Insulin Not Harmful in Type 2 Diabetes.january 29, 2019.MedScape.

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