title: Resource utilization with insulin pump therapy for type 2 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate the effects of switching from multiple daily injection (MDI) therapy to insulin pump therapy, also called continuous subcutaneous insulin infusion (CSII), on antidiabetic drug and healthcare resource utilization.
  
  
  METHODS
  This study was a retrospective analysis of administrative claims data from a large geographically diverse health plan in the United States from January 1, 2005, through April 30, 2008.
  
  
  METHODS
  Changes in antidiabetic drug use, antidiabetic drug switching and augmentation, and healthcare utilization during the baseline period and after CSII initiation were assessed using paired t test.
  
  
  RESULTS
  There were 3649 possible subjects, of whom 943 met the criteria for analysis. The mean number of antidiabetic drugs used decreased by 46% after CSII initiation, and the mean reduction in antidiabetic drug utilization was 0.67; both were statistically significant. More than one-third of subjects who were taking antidiabetic drugs before CSII initiation discontinued oral therapy after CSII initiation. The number of subjects using multiple antidiabetic drugs significantly decreased after CSII initiation by 58%, and rates of switching or augmenting significantly decreased from 42% at baseline to 25% after CSII initiation.The rates of emergency department visits and inpatient admissions significantly decreased, and the rate of ambulatory visits significantly increased.
  
  
  CONCLUSIONS
  CSII was associated with significant decreases in antidiabetic drug and healthcare resource utilization, contributing to stability of care. The evidence from this study indicates that CSII should be considered as an option for patients with type 2 diabetes mellitus who are using MDI and are experiencing a high degree of antidiabetic drug and healthcare resource utilization.
authors.affiliation: Medtronic, Inc, 18000 Devonshire St, Northridge, CA 91325, USA. peter.m.lynch@medtronic.com
authors.forename: Peter M
authors.initials: PM
authors.lastname: Lynch
authors.forename: Aylin Altan
authors.initials: AA
authors.lastname: Riedel
authors.forename: Navendu
authors.initials: N
authors.lastname: Samant
authors.forename: Ying
authors.initials: Y
authors.lastname: Fan
authors.forename: Tim
authors.initials: T
authors.lastname: Peoples
authors.forename: Jennifer
authors.initials: J
authors.lastname: Levinson
authors.forename: Scott W
authors.initials: SW
authors.lastname: Lee
mesh_terms: D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000191:economics* / Q000706:statistics & numerical data; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin