Cost Change After Initiating Basal Insulin for 6 Months in Patients with Type 2 Diabetes: A Registry Study in China
Dongshan Zhu,
Xian Li,
Jiachao Ji,
Juming Lu,
Weiping Jia,
Linong Ji,
Puhong Zhang
Issue:
Volume 4, Issue 3, September 2019
Pages:
62-72
Received:
18 July 2019
Accepted:
13 August 2019
Published:
3 September 2019
Abstract: This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C≥7%) by oral antidiabetic drugs (OADs) and willing to initiate basal insulin treatment were enrolled from 209 hospitals of eight geographic regions of China. Type and dose of BI were at the physician’s discretion and patients’ willingness. Interviews were conducted at baseline, month 3 and month 6. Daily treatment cost (including cost of OAD medication, insulin therapy, self-monitoring of blood glucose and dealing with minor hypoglycemia) of per person before and after adding BIs was evaluated. After adding on Basal insulin, the weighted mean ± standard deviation (SD) daily treatment cost for insulin-naïve patients with type 2 diabetes increased from $1.25 ± $0.74 (baseline) to $2.57 ± $0.68 at month 6, a median (Q1, Q3) increase of 1.51 (0.38, 4.11) times over 6 months. The daily treatment cost increased with growing baseline HbA1c level and prolonged diabetes duration. The reduction in HbA1c was 2.2%, with minor hypoglycemia increased by 0.68 times/person/year. Insulin cost accounted for the highest proportion (47.9%) of costs. Our findings suggest adding-on BI therapy may increase the daily treatment cost by 1.5 times at 6 months. Early initiation of BI therapy may provide an opportunity to achieve treatment goals with low cost and low risk of hypoglycemia.
Abstract: This study aims to examine short-term treatment cost changes after initiating basal insulin in insulin naïve patients with type 2 diabetes for 6 months in routine clinical practice. Observational Registry of Basal Insulin Treatment (ORBIT) program is a 6-month, prospective study in China. Patients with type 2 diabetes inadequately controlled (HbA1C...
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Review of FIGO & ADA, WHO, IADPSG Guidelines for GDM for Low Resource Setting and Integration of DIPSI with MOHFW Govt of India, Guidelines
Rajesh Jain,
Susanne Olejas,
Lee Sam Goo,
N. Bhavatharinin,
Ashish S. Dengra,
Reza Shoghli,
Sanjeev Davey,
Rachna Jain
Issue:
Volume 4, Issue 3, September 2019
Pages:
73-82
Received:
21 May 2019
Accepted:
19 July 2019
Published:
4 September 2019
Abstract: OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting after 2-hour ingesting 75 grams of glucose (Monohydrate Dextrose Anhydrous). For diagnosing gestational diabetes (GDM) Indian Guidelines (DIPSI Test) are simple and can be done easily in low resource setting where large number of pregnant women visit for ANC check-up. The severity of GDM increases because of the action of insulin is diminished (insulin resistance) due to raised hormone secretion by the placenta. Other risk factors for GDM are being elderly, increased BMI, or obesity, weight gain in pregnancy, history of diabetes in family, stillbirth or a congenital abnormality in previous deliveries. GDM has previously been considered to be transient during pregnancy and resolve after pregnancy but, pregnant women with hyperglycaemia are at higher risk of developing GDM in subsequent pregnancies and about half of the women with a history of GDM will develop type II Diabetes within five to ten years after delivery. DIPSI simple testing protocol is endorsed by the National Health Mission (GOI) Guideline on GDM, and also endorsed by the FIGO guideline on HIP for use in South Asia. This testing protocol has been followed by Sri Lanka, Pakistan and Bangladesh in the region. Tamil-Nadu state and Uttar Pradesh states in India launched a Universal GDM Program in 2007 and 2016 respectively, covering all pregnancies by testing and managing GDM with MNT, Metformin and Insulin in most of health care facilities. Around 28,000 ANM have been given glucometers, strips, glucose 75 gm packets for implementation of the largest GDM program in Uttar Pradesh, India to date.
Abstract: OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting after 2-hour ingesting 75 grams of glucose (Monohydrate Dextrose Anhydrous). For diagnosing gestational diabetes (GDM) Indian Guidelines (DIPSI Test) are simple and can be done easily in low resource setting where large number of pregnant women visit for A...
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Effect of Using Mobile Phone Communication on Morbidity and Health Seeking Behavior of Type 2 Diabetes Mellitus Patients at Kitui County Referral Hospital, Kenya
Theuri Alice Wairimu,
Makokha Anselimo,
Kyallo Florence
Issue:
Volume 4, Issue 3, September 2019
Pages:
83-89
Received:
20 June 2019
Accepted:
22 August 2019
Published:
5 September 2019
Abstract: There is an increasing prevalence of Type 2 Diabetes Mellitus (T2DM) in Kenya. This is despite the implementations of various interventions to prevent and manage the condition. Despite increasing use of mobile phone communication in Kenya, this technology has not been utilized in management of T2DM, though it has been applied in other countries. The objective of this study was to determine the effect of using mobile phone communication on the morbidity and health seeking behavior of T2DM patients. The study was conducted among 138 patients attending the diabetes clinic at Kitui County Referral Hospital. A pretested questionnaire was used to collect data on socio economic characteristics, morbidity status and health seeking behavior at the baseline and after mobile phone based intervention. There was a greater decline in morbidity in the experimental group (35.8% to 22.4%) compared to the control group (31% to 29.6%). The difference between groups was significant (OR=0.48; 95% CI= 0.27-0.85), p<0.05). The proportion of respondents with controlled blood pressure (BP) increased in experimental group (44.8% to 49.3%) compared to a reduction in the control group (53.5% to 47.9%). The effect of the intervention was significant (p<0.05). Self-monitoring of blood glucose (SMBG) increased from 32.8% to 41.8% in experimental group while it reduced from 39.4% to 31% in control group. The effect of the intervention was statistically significant (p<0.05). This study concludes that use of mobile phone communication led to significant decrease in morbidity prevalence and an increase in the proportion of T2DM patients that carried out self-monitoring of blood glucose in T2DM patients while it did not have a significant effect on glycemic control, diabetes clinic attendance and monitoring of feet health.
Abstract: There is an increasing prevalence of Type 2 Diabetes Mellitus (T2DM) in Kenya. This is despite the implementations of various interventions to prevent and manage the condition. Despite increasing use of mobile phone communication in Kenya, this technology has not been utilized in management of T2DM, though it has been applied in other countries. Th...
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