title: Resource utilisation and quality of life following initiation of insulin detemir in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Barriers to insulin initiation in type 2 diabetes mellitus (T2DM) include fear of treatment complexity and perceived lack of time and resources by primary care physicians. The SOLVE study investigated the effect of insulin initiation on resource utilisation and patient quality of life.
  
  
  METHODS
  SOLVE was a 24-week cohort study in 10 countries evaluating the safety and effectiveness of initiating once-daily insulin detemir in patients with T2DM. Patient quality of life was assessed using the Insulin Treatment Appraisal Scale (ITAS).
  
  
  RESULTS
  A total of 14,611 (84%) patients completed the 24-week study. During the study, HbA1c improved by 1.3 ± 1.5%. The corresponding insulin dose increased from 13 ± 6 IU (0.16 ± 0.09 IU/kg) at baseline, to 22 ± 16 IU (0.27 ± 0.17 IU/kg) at final visit. FlexPen was the preferred device (63%) for insulin administration. The time taken to teach patients to self-inject and perform dose self-adjustment was 15 ± 13 min and 11 ± 11 min, respectively. The quality of life analysis included 6875 patients. The addition of insulin was associated with an improvement in mean ITAS score [-3.5 (95% CI -3.8, -3.3), p < 0.001]. Physicians reported the use or self-adjustment of insulin detemir as easy or very easy in 79% of participants; and satisfaction with the level of glycaemic control was reported for 74% of patients.
  
  
  CONCLUSIONS
  Initiating basal insulin therapy resulted in a substantial decrease in HbA1c and improved patients' perceptions of insulin treatment.
authors.affiliation: Center for Diabetes and Metabolism, m&i-Fachklinik Bad Heilbrunn, Bad Heilbrunn, Germany. andreas.liebl@fachklinikbad-heilbrunn.de
authors.forename: A
authors.initials: A
authors.lastname: Liebl
authors.forename: H
authors.initials: H
authors.lastname: Andersen
authors.forename: A L
authors.initials: AL
authors.lastname: Svendsen
authors.forename: J
authors.initials: J
authors.lastname: Vora
authors.forename: J-F
authors.initials: JF
authors.lastname: Yale
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000534:rehabilitation; D004334:Drug Administration Schedule; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007271:Injections, Intradermal; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011788:Quality of Life
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir