title: Real-world insulin treatment persistence among patients with type 2 diabetes.
abstract: OBJECTIVE
  To evaluate real-world treatment persistence among patients with type 2 diabetes mellitus (T2DM) initiating treatment with insulin.
  
  
  METHODS
  Patient-level data were pooled from 3 previously published observational retrospective studies evaluating patients with T2DM who were previously on oral antidiabetic drugs (OADs) and initiated with a basal analog insulin (insulin glargine or insulin detemir). Treatment persistence was defined as remaining on the study drug during the 1-year follow-up period without discontinuation or switching after study drug initiation. Analyses were conducted to identify baseline factors associated with persistence with insulin therapy and to estimate the association between insulin treatment persistence and patients' clinical and economic outcomes during the follow-up period.
  
  
  RESULTS
  A total of 4,804 patients with T2DM (insulin glargine: n = 4,172, insulin detemir: n = 632) were included. The average insulin persistence rate over the 1-year follow-up period was 65.0%. A significantly higher persistence rate was associated with older age, initiation with insulin glargine using either disposable pens or vial-and-syringe, and with baseline exenatide or sitagliptin use. Higher insulin treatment persistence was also associated with lower hemoglobin A1c (A1C) at follow-up, a greater reduction in A1C from baseline, and lower health care utilization.
  
  
  CONCLUSIONS
  In real-world settings, treatment persistence among patients with T2DM initiating basal insulin is influenced by the type of insulin and patient factors. Greater insulin treatment persistence is linked to improved clinical outcomes and reduced health care utilization.
authors.affiliation: Sanofi U.S., Inc., Bridgewater, New Jersey.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Wei
authors.affiliation: PRO Unlimited, Boca Raton, Florida.
authors.forename: Chunshen
authors.initials: C
authors.lastname: Pan
authors.affiliation: STATinMED Research, Inc., Ann Arbor, Michigan.
authors.forename: Lin
authors.initials: L
authors.lastname: Xie
authors.affiliation: University of Michigan, Ann Arbor, Michigan.
authors.forename: Onur
authors.initials: O
authors.lastname: Baser
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human