Effects of insulin initiation on patient-reported outcomes in patients with type 2 diabetes: Results from the DURABLE trial

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• 作者：Lauren J. Lee ; Jessie L. Fahrbach ; Lauren M. Nelson ; Lori D. McLeod ; Sherry A. Martin ; Peter Sun ; Ruth S. Weinstock
• 关键词：Quality of life ; Insulin initiation ; Symptoms
• 刊名：Diabetes Research and Clinical Practice
• 出版年：2010
• 出版时间：August 2010
• 年：2010
• 卷：89
• 期：2
• 页码：157-166
• 全文大小：228 K

文摘

Aim

To examine changes in patient-reported outcome (PRO) measures in patients with type 2 diabetes (T2DM) on oral agents who initiated insulin (insulin lispro mix 25/75 [LM25] or insulin glargine) in the DURABLE trial (n = 580).

Methods

Subjects completed generic and diabetes-specific health-related quality-of-life measures (RAND-36 and Diabetes-39) and a symptom assessment measure (DSC-Revised) at baseline and 6 months post insulin initiation. Mean score change was evaluated. Effect size (ES; Cohen's d) and analysis of covariance were used to examine extent and significance of change both within and between treatment groups.

Results

Subject characteristics were mean age 57 years, males 59 % , duration of diabetes 9.6 years, and baseline HbA1c 8.9 % . In the total sample, significant (P < 0.01) improvements (with small ES) were observed in four of eight RAND-36 subscales (ES range: 0.13–0.24), three of five Diabetes-39 subscales (ES range: 0.09–0.34), and five of eight DSC-Revised subscales (ES range: 0.15–0.38). While significance of within-group changes varied by treatment, only one subscale (physical functioning for LM25) showed deterioration. The changes were not significantly different (P > 0.01) between regimens for any subscales.

Conclusions

Our findings suggest that insulin initiation improves selective PRO in patients with poorly controlled T2DM.