Improvements in quality of life associated with biphasic insulin aspart 30 in type 2 diabetes patients in China: results from the A1chieve® observational study

Wenying Yang, Xiaoming Zhuang, Yukun Li, Qing Wang, Rongwen Bian, Jianguo Shen, Eva Hammerby, Li Yang, Wenying Yang, Xiaoming Zhuang, Yukun Li, Qing Wang, Rongwen Bian, Jianguo Shen, Eva Hammerby, Li Yang

Abstract

Background: Based on the 24-week, prospective, non-interventional, observational study, A1chieve®, we investigated how health-related quality of life (HRQoL) changed, and the predictors of such changes, in Chinese people with type 2 diabetes mellitus (T2DM) after starting with, or switching to, biphasic insulin aspart 30 (BIAsp 30).

Methods: In total, 8,578 people with T2DM starting treatment with, or switching to, BIAsp 30 were recruited from 130 urban hospitals in China. HRQoL was assessed at baseline and 24 weeks using the EuroQol-5 dimensions (EQ-5D) questionnaire. Descriptive statistics, paired t-test, and chi-square test were conducted and the linear ordinary least squares regression model was used to determine predictors for changes in EQ-5D score.

Results: Haemoglobin A1c (HbA1c) decreased from 9.5% to 7.0% after 24 weeks. The reported HRQoL measured by the EQ-5D visual analogue scale score increased by 6.2 (p < 0.001) from 75.8 to 82.0, and EQ-5D index score increased by 0.018 (p < 0.001) from 0.875 to 0.893 for the cohort over 24 weeks. The percentage of patients reporting no problems in the mobility, pain/discomfort, and anxiety/depression dimensions of EQ-5D increased significantly (p < 0.001) from 88.4% to 91.4%, 77.3% to 82.8%, and 74.2% to 77.1%, respectively. Patients with higher HbA1c levels at baseline, major hypoglycaemia or micro-complications exhibited significantly larger changes in EQ-5D scores than those with lower baseline HbA1c levels, without major hypoglycaemia or micro-complications after controlling for demographics and other baseline characteristics.

Conclusions: BIAsp 30 treatment was associated with improved glycaemic control and HRQoL in T2DM patients in China. Patients with worse health conditions were more likely to experience larger improvements in HRQoL than those with better health conditions.

Trial registration: ClinicalTrials.gov, NCT00869908 .

References

    1. International Diabetes Federation. Diabetes Atlas. 5th edition 2012 update. .
    1. Xu Y, Wang L, He J, Bi Y, Li M, Wang T, Wang L, Jiang Y, Dai M, Lu J, Xu M, Li Y, Hu N, Li J, Mi S, Chen CS, Li G, Mu Y, Zhao J, Kong L, Chen J, Lai S, Wang W, Zhao W, Ning G, China Noncommunicable Disease Surveillance Group Prevalence and control of diabetes in Chinese adults. JAMA. 2010;2013(310):948–958.
    1. International Diabetes Federation: China spends RMB 173.4 billion (US$25 billion) a year on diabetes treatment. .
    1. Wu N, Aagren M, Boulanger L, Friedman M, Wilkey K. Assessing achievement and maintenance of glycemic control by patients initiating basal insulin. Curr Med Res Opin. 2012;28:1647–1656. doi: 10.1185/03007995.2012.722989.
    1. Massi-Benedetti M, Orsini-Federici M. Treatment of type 2 diabetes with combined therapy: what are the pros and cons? Diabetes Care. 2008;31(Suppl 2):S131–S135. doi: 10.2337/dc08-s233.
    1. Pouwer F, Hermanns N. Insulin therapy and quality of life. A review. Diabetes Metab Res Rev. 2009;25(Suppl 1):S4–S10. doi: 10.1002/dmrr.981.
    1. Funnell MM. Quality of life and insulin therapy in type 2 diabetes mellitus. Insulin. 2008;3:31–36. doi: 10.1016/S1557-0843(08)80009-7.
    1. Vinik AI, Zhang Q. Adding insulin glargine versus rosiglitazone: health-related quality-of-life impact in type 2 diabetes. Diabetes Care. 2007;30:795–800. doi: 10.2337/dc06-1712.
    1. Houlden R, Ross S, Harris S, Yale JF, Sauriol L, Gerstein HC. Treatment satisfaction and quality of life using an early insulinization strategy with insulin glargine compared to an adjusted oral therapy in the management of type 2 diabetes: the Canadian INSIGHT study. Diabetes Res Clin Pract. 2007;78:254–258. doi: 10.1016/j.diabres.2007.03.021.
    1. Jacobson AM. Impact of improved glycemic control on quality of life in patients with diabetes. Endocr Pract. 2004;10:502–508. doi: 10.4158/EP.10.6.502.
    1. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care. 2002;25:458–463. doi: 10.2337/diacare.25.3.458.
    1. Davis RE, Morrissey M, Peters JR, Wittrup-Jensen K, Kennedy-Martin T, Currie CJ. Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes. Curr Med Res Opin. 2005;21:1477–1483. doi: 10.1185/030079905X61929.
    1. Barendse S, Singh H, Frier BM, Speight J. The impact of hypoglycaemia on quality of life and related patient-reported outcomes in Type 2 diabetes: a narrative review. Diabet Med. 2011;29:293–302. doi: 10.1111/j.1464-5491.2011.03416.x.
    1. Shah SN, Litwak L, Haddad J, Chakkarwar PN, Hajjaji I: The A1chieve study: a 60 000-person, global, prospective, observational study of basal, meal-time, and biphasic insulin analogs in daily clinical practice.Diabetes Res Clin Pract 2010, 88(Suppl 1):S11–S16.
    1. EuroQol Group EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208. doi: 10.1016/0168-8510(90)90421-9.
    1. EuroQol Group. .
    1. Wang HM, Patrick DL, Edwards TC, Skalicky AM, Zeng HY, Gu WW. Validation of the EQ-5D in a general population sample in urban China. Qual Life Res. 2012;21:155–160. doi: 10.1007/s11136-011-9915-6.
    1. Sun S, Chen J, Johannesson M, Kind P, Xu L, Zhang Y, Burström K. Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the national health services survey 2008. Qual Life Res. 2011;20:309–320. doi: 10.1007/s11136-010-9762-x.
    1. Wang H, Kindig DA, Mullahy J. Variation in Chinese population health related quality of life: results from a EuroQol study in Beijing, China. Qual Life Res. 2005;14:119–132. doi: 10.1007/s11136-004-0612-6.
    1. Sheu WH, Ji LN, Nitiyanant W, Baik SH, Yin D, Mavros P, Chan SP. Hypoglycemia is associated with increased worry and lower quality of life among patients with type 2 diabetes treated with oral antihyperglycemic agents in the Asia-Pacific region. Diabetes Res Clin Pract. 2012;96:141–148. doi: 10.1016/j.diabres.2011.12.027.
    1. Li H, Wei X, Ma A, Chung RY. Inequalities in health status among rural residents: EQ-5D findings from household survey China. Int J Equity Health. 2014;13:41–48. doi: 10.1186/1475-9276-13-41.
    1. Liang Y, Lu W, Wu W. Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? A study on the effect of social security policies for Chinese landless farmers on their health-related quality of life. Int J Equity Health. 2014;13:5–20. doi: 10.1186/1475-9276-13-5.
    1. Yang W, Li Y, Chen L, Shi Y, Peng Y, Lei M: Clinical use of daily biphasic insulin aspart 30 in Chinese people with type 2 diabetes: results of A1chieve observational study.Chin J Diabetes Mellitus 2012, 4:607–612.
    1. Shah S, Zilov A, Malek R, Soewondo P, Bech O, Litwak L: Improvements in quality of life associated with insulin analogue therapies in people with type 2 diabetes: results from the A1chieve observational study.Diabetes Res Clin Pract 2011, 94:364–370.
    1. Moses A, Chawla R, John W. Insulin analogue therapy improves quality of life in patients with type 2 diabetes in India: the A1chieve Study. J Assoc Phys India. 2013;61(Suppl.1):31–40.
    1. Schmoelzer I, de Campo A, Pressl H, Stelzl H, Dittrich P, Oettl K. Biphasic insulin aspart compared to biphasic human insulin reduces postprandial hyperlipidemia in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2005;113:176–181. doi: 10.1055/s-2005-837521.
    1. McSorley PT, Bell PM, Jacobsen LV, Kristensen A, Lindholm A. Twice-daily biphasic insulin aspart 30 versus biphasic human insulin 30: a double-blind crossover study in adults with type 2 diabetes mellitus. Clin Ther. 2002;24:530–539. doi: 10.1016/S0149-2918(02)85129-3.
    1. Tamemoto H, Ikoma A, Saitoh T, Ishikawa SE, Kawakami M. Comparison of once-daily glargine plus sulfonylurea with twice-daily 70/30 aspart premix in insulin-naive Japanese patients with diabetes. Diabetes Technol Ther. 2007;9:246–253. doi: 10.1089/dia.2006.0016.
    1. Kilo C, Mezitis N, Jain R, Mersey J, McGill J, Raskin P. Starting patients with type 2 diabetes on insulin therapy using once-daily injections of biphasic insulin aspart 70/30, biphasic human insulin 70/30, or NPH insulin in combination with metformin. J Diabetes Complications. 2003;17:307–313. doi: 10.1016/S1056-8727(03)00076-X.
    1. Raskin P, Allen E, Hollander P, Lewin A, Gabbay RA, Hu P. Initiating insulin therapy in type 2 diabetes: a comparison of biphasic and basal insulin analogs. Diabetes Care. 2005;28:260–265. doi: 10.2337/diacare.28.2.260.
    1. Home H, Naggar NE, Khamseh M, Gonzalez-Galvez G, Shen C, Chakkarwar P: An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: The A1chieve study.Diabetes Res Clin Pract 2011, 94:352–363.
    1. Valensi P, Benroubi M, Borzi V. Initiating insulin therapy with, or switching existing insulin therapy to, biphasic insulin aspart 30⁄70 (NovoMixR 30) in routine care: safety and effectiveness in patients with type 2 diabetes in the IMPROVETM observational study. Int J Clin Pract. 2009;63:522–531. doi: 10.1111/j.1742-1241.2009.02002.x.
    1. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15:205–218. doi: 10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>;2-O.
    1. Magwood GS, Zapka J, Jenkins CA. Review of systematic reviews evaluating diabetes interventions: focus on quality of life and disparities. Diabetes Educ. 2008;34:242–265. doi: 10.1177/0145721708316551.
    1. Zhang X, Norris SL, Chowdhury FM, Gregg EW, Zhang P. The effects of interventions on health-related quality of life among persons with diabetes: a systematic review. Med Care. 2007;45:820–834. doi: 10.1097/MLR.0b013e3180618b55.
    1. Barendse S, Singh H, Frier BM, Speight J. The impact of hypoglycaemia on quality of life and related patient-reported outcomes in Type 2 diabetes: a narrative review. Diabet Med. 2012;29:293–302. doi: 10.1111/j.1464-5491.2011.03416.x.

Source: PubMed

3
Iratkozz fel