title: Different injection frequencies of basal insulins in type 2 diabetes patients under real-life conditions: a retrospective database analysis.
abstract: OBJECTIVE
  Little is known about routine use of basal insulins [glargine, detemir, neutral protamine Hagedorn (NPH)] in primary care patients with type 2 diabetes. The aim was to compare injection frequencies of basal insulins in type 2 diabetes in primary care practices, both for basal-supported oral therapy (BOT) and basal-bolus treatment [intensified conventional therapy (ICT)] regimens.
  
  
  METHODS
  Primary care data from 4211 glargine (BOT/ICT, 2247/1964), 1290 detemir (490/800), and 3876 NPH (1331/2425) insulin users were retrospectively analyzed (Disease Analyzer database, May 2009-April 2012). Logistic regression (>1 daily injection) and propensity scores were used to adjust for various confounders (age, sex, type of physician, dosage, body mass index, glycosylated hemoglobin).
  
  
  RESULTS
  Overall, >1 daily injections were observed in 7.5% of glargine users (BOT, 6.2%; ICT, 9.0%), which was lower than for detemir (overall, 25.4%; BOT, 22.0%; ICT, 27.4%) and NPH (25.4%; BOT, 23.9%; ICT, 27.2%) insulin (all p < .001). The adjusted odds of having >1 injection was lower for glargine compared with detemir (odds ratio, 0.26; 95% CI 0.22-0.32) and NPH-insulin (0.20; 0.17-0.23). Similar results were found for BOT or ICT and after propensity score matching.
  
  
  CONCLUSIONS
  Glargine is associated with significantly lower injection frequencies than other basal insulins. These findings might impact patient-reported outcomes, quality of life, treatment satisfaction, and economic aspects of diabetes treatment.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Franz W
authors.initials: FW
authors.lastname: Dippel
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
mesh_terms: D000368:Aged; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin