2. Lilly Deutschland GmbH, Werner-Reimers-Straße 2, 61352 Bad Homburg vor der Höhe, Germany.
3. Eli Lilly and Company, 893 S Delaware St, Indianapolis, IN 46225, USA.
4. Analysis Group, Inc, 10 Rockefeller Plaza 15, New York, NY 10020, USA.
5. Hospital Universitario Fundación Alcorcón, Calle Budapest 1, 28922 Alcorón, Madrid, Spain.
Background: The real-world effectiveness of insulin therapy is influenced by poor treatment persistence. An international cross-sectional survey of people with type 2 diabetes mellitus (T2DM) was conducted to assess experiences before, during, and after basal insulin initiation, and to describe reasons for early nonpersistence with insulin therapy. A sub-analysis based on the Spanish cohort and notable between-group comparisons are presented.
Patients and methods: Responders to an online survey in seven countries were classified as continuers (no gap in insulin treatment ≥7 days), interrupters (interrupted therapy for ≥7 days within first 6 months, then restarted) and discontinuers (stopped insulin therapy within first 6 months and did not restart before the survey). Data from the Spanish subpopulation were analysed in combination and separately for the three persistence pattern groups.
Results: Of 942 global respondents, 150 (50 continuers, 50 interrupters, 50 discontinuers) were from Spain, with a mean age of 36 years and a mean of 6 years since first T2DM diagnosis. Reasons contributing to insulin continuation were improved glycaemic control (70%) followed by improved physical feeling and the convenience of insulin relative to other diabetes treatments (both 46%). Common reasons for interruption were weight gain (46%), hypoglycaemia and the inconvenience of using insulin (both 40%). Most common reasons for discontinuation were weight gain and pain from injections (both 40%) followed by the dislike/ fear of needles (34%).
Conclusion: The benefits of basal insulin therapy motivated continuers to persist with the treatment, whereas experienced or anticipated side effects and injection concerns contributed to interruption and discontinuation. Understanding factors affecting persistence patterns among Spanish patients with T2DM may help clinicians improve successful continuation of basal insulin therapy.
Keywords: Type 2 diabetes, persistence patterns, basal insulin, long-acting insulin, insulin initiation, Spain