Impact of Switching to Analogue Insulin on Diabetes Control and Costs
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Evaluating the Impact of Intensifying Treatment from Human to Analogue Insulin on Glycaemic Control and Insulin Expenditure in Patients with Type 2 Diabetes: A Retrospective Cohort Study
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Siti Aisyah Hussin, Nur Aimi Mohamad, Mohd Khairi Othman, Wan Mohd Izani Wan Mohamed
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Evaluating the Impact of Intensifying Treatment from Human to Analogue Insulin on Glycaemic Control and Insulin Expenditure in Patients with Type 2 Diabetes: A Retrospective Cohort Study
Year: 2024 | Doi: 10.21315/mjms2024.31.2.14
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Diabetes mellitus (DM) is a global health concern that significantly contributes to morbidity and mortality. In Malaysia, the prevalence of diabetes among adults is expected to rise, highlighting the urgency of effective management strategies. Achieving good glycemic control is crucial in minimizing complications related to diabetes, with the standard treatment involving insulin. However, the transition from human to analogue insulin, despite its potential benefits, raises concerns about associated costs and significant clinical improvements. This study investigates the efficacy of this transition specifically at Hospital Universiti Sains Malaysia (HUSM), aiming to evaluate its glycemic control outcomes and cost implications over a three-month period.
Efficacy of Insulin Intensification
The study found that although there were statistically significant reductions in HbA1c and fasting blood sugar (FBS) levels after transitioning from human to analogue insulin, these changes were not clinically significant, falling short of a 0.5% reduction in HbA1c, which is considered the threshold for clinical significance according to guidelines. Furthermore, patients incurred higher costs with analogue insulin, averaging RM 397.55 compared to RM 104.70 for human insulin over three months. This signifies that while patients experienced some improvements in glycemic control, the additional financial burden associated with analogue insulin may not yield adequate clinical benefits, making it crucial to evaluate which patients would maximize the advantages of using insulin analogues without excessive costs.
Conclusion
This study concludes that transitioning from human to analogue insulin does not present clinically significant enhancements in glycemic control for patients with type 2 diabetes mellitus, despite considerably higher costs. To optimize resources in a healthcare system with limited financial capabilities, careful patient selection is essential to ensure that those most likely to benefit from analogue insulin receive it. Future research should explore longer-term effects and include considerations for additional factors like hypoglycemic events, medication adherence, and overall patient quality of life for a more comprehensive understanding of the efficacy and value of insulin analogues in diabetes management.
FAQ section (important questions/answers):
What is the main goal of this study?
The study aimed to evaluate the efficacy and cost implications of switching patients with type 2 diabetes from human insulin to analogue insulin for better glycaemic control and to identify if the costs are justified by the benefits.
How many patients were included in the study?
A total of 163 patients with type 2 diabetes mellitus who underwent insulin intensification from human to analogue insulin for at least three months were included in the study at Hospital Universiti Sains Malaysia.
What were the results regarding HbA1c levels?
The study found that while there was a decrease in HbA1c levels after switching to analogue insulin, the reduction was statistically significant but clinically not meaningful, as it was less than 0.5%.
What conclusion did the study reach about insulin costs?
The study concluded that despite the lack of significant clinical improvement in glycaemic control, the cost for analogue insulin was significantly higher than for human insulin, highlighting the need for careful patient selection for such treatments.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Impact of Switching to Analogue Insulin on Diabetes Control and Costs”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
In research, a study refers to a systematic investigation designed to analyze a specific phenomenon or question. This includes collecting, analyzing, and interpreting data to derive conclusions. Studies hold significance for establishing evidence-based practices, improving methodologies, and advancing knowledge in various fields, including healthcare, social sciences, and education.
2) Table:
A table is an organized arrangement of data, typically presented in rows and columns. It facilitates the clear comparison and analysis of information, such as statistical data. In research papers, tables are crucial for summarizing outcomes, demographics, or results, providing visual clarity and enabling readers to understand findings efficiently.
3) Blood:
Blood is a vital bodily fluid that transports oxygen and nutrients to cells while removing waste products. In medical contexts, blood is often analyzed to evaluate health conditions, such as diabetes and other diseases. Blood tests, including glucose monitoring, play a critical role in diagnosing and managing various health issues.
4) Quality:
Quality refers to the degree of excellence of a particular characteristic or entity, often assessed in terms of effectiveness, safety, and satisfaction. In healthcare, quality is critical for evaluating patient outcomes and the efficacy of treatments. High-quality care improves patient experiences, health outcomes, and overall system performance.
5) Post:
In the context of academic research, 'post' typically refers to the period following an intervention, experiment, or treatment. It is crucial for measuring outcomes, changes, or effects that occur after the implementation of a specific procedure. This is especially relevant for assessing the long-term impacts of medical therapies.
6) Life:
Life encompasses the existence of living organisms, characterized by growth, reproduction, and responses to stimuli. In health research, particularly in studies related to diabetes, quality of life measures assess the impact of medical conditions and treatments on individuals' daily living, emotional well-being, and overall health satisfaction.
7) Sugar:
Sugar, particularly in the context of health and nutrition, refers to simple carbohydrates that provide energy but can affect blood glucose levels. Excessive sugar consumption is linked to conditions like diabetes. As such, monitoring sugar intake is essential for managing diabetes and promoting overall health and well-being.
8) Ter:
Short for 'therapy,' it often signifies various treatment methods aimed at alleviating disease symptoms or enhancing health. In medical research, understanding different therapeutic approaches, including pharmacological and non-pharmacological options, is fundamental for improving patient outcomes and developing effective treatment guidelines for conditions such as diabetes mellitus.
9) Drug:
A drug is a chemical substance used to diagnose, treat, or prevent diseases. In healthcare, drugs include medications for various conditions, including insulin for diabetes management. Research into drug efficacy and safety is crucial for determining appropriate treatments, minimizing adverse effects, and ensuring patient adherence to medical recommendations.
10) Rules:
In research, rules establish guidelines or criteria for conducting studies, data collection, and analysis. They ensure methodological rigor, ethical considerations, and reliable results. Understanding the rules governing research practices is essential for maintaining integrity, fostering collaboration, and advancing knowledge in scientific communities, healthcare, and beyond.
11) Cina:
China serves as a significant context in global health research due to its vast population and variance in health issues, including diabetes management. Investigating diabetes treatments, public health policies, and healthcare accessibility within China provides insight into managing chronic diseases in rapidly developing countries, informing practices worldwide.
12) Male:
This term denotes individuals of the male sex, which can impact health outcomes differently than females due to biological, lifestyle, and social factors. In diabetes research, studies often analyze gender differences in disease prevalence, treatment responses, and complications, ensuring tailored healthcare strategies that address specific needs of male patients.
13) Calculation:
Calculation refers to the mathematical processes used to derive numerical data, essential for analyzing research findings. In studies, accurate calculations determine dosing, cost-effectiveness, and statistical significance. They enable researchers to quantify effects, compare results across populations, and support conclusions, thus playing a pivotal role in scientific inquiry.
14) Knowledge:
Knowledge signifies the information, understanding, and skills acquired through education or experience. In healthcare, it relates to recognizing diabetes management and treatment options. Enhancing knowledge among healthcare professionals and patients is critical for informed decision-making, effective self-management, and improving health outcomes within the context of chronic disease management.
15) Maruthur:
Maruthur refers to one of the researchers or a notable contributor within the academic and medical community, particularly in diabetes studies. Acknowledging individuals like Maruthur is vital for crediting work and advances in understanding diabetes and its management through research, findings, and improving patient care strategies.
16) Science (Scientific):
Science embodies the systematic study and knowledge acquisition regarding the natural world through observation and experimentation. In health research, scientific principles guide the exploration of diseases, treatments, and public health policies. The scientific method is fundamental for establishing evidence, validating findings, and advancing medical knowledge significantly.
17) Reason:
Reason pertains to the rationale or justification behind actions, conclusions, or beliefs. In healthcare research, understanding the reasons for patient outcomes, treatment choices, or disease progression helps refine practices and interventions. Clear reasoning ensures that health policies and research are grounded in understanding, facilitating effective healthcare solutions.
18) Bharu:
Kota Bharu is a city in Malaysia, which serves as a significant focus area for diabetes research due to the local population's health challenges. Understanding diabetes prevalence, treatment practices, and patient experiences in Kota Bharu can inform broader strategies in managing diabetes in similar communities and contribute to healthcare advancements.
19) Kota:
Kota translates to 'city' in Malay, and it indicates urban areas that may face unique health challenges, including diabetes management. Research focused on urban populations like Kota Bharu provides insight into healthcare accessibility, lifestyle influences, and public health initiatives, aiding the design of targeted interventions in similar settings.
20) Dali:
Dali is a surname associated with researchers in health studies, particularly in Malaysia. Recognizing contributions of individuals like Dali in diabetes research is important to ensure that efforts and findings in this area are credited, promoting collaboration and continued scholarly work towards effective diabetes management.
21) Pur:
Poor often describes lower socio-economic status or inadequate access to resources. In health research, it is used to highlight disparities in healthcare access, diabetes care, and quality of life. Understanding the challenges faced by poorer populations is crucial for developing inclusive strategies aimed at improving health outcomes.
22) Discussion:
Discussion is a critical section in academic papers where researchers interpret findings, draw connections, and explore implications of their results. This part fosters dialogue and reflection on research questions, emphasizing the significance of the study, identifying limitations, and suggesting future research directions to enhance understanding and advance healthcare.
23) Developing:
Developing refers to countries or regions with emerging economies typically facing healthcare challenges, including diabetes management. Research focused on developing regions is vital for understanding unique health needs, quantifying disease impact, and informing effective healthcare interventions that cater specifically to the public health challenges present in these areas.
24) Activity:
Activity encompasses any form of movement or engagement that influences health. In diabetes management, physical activity plays a significant role in regulating blood glucose levels and improving overall health. Research into activity levels among diabetic patients contributes to developing effective lifestyle recommendations and interventions tailored for enhanced health outcomes.
25) Visit:
Visit refers to appointments or consultations in healthcare settings. In diabetes management, regular patient visits are essential for monitoring progress, adjusting treatment plans, and providing education. Research into visit frequency and quality helps understand patient adherence, healthcare access, and the effectiveness of diabetes management programs.
26) Money:
Money represents the financial aspect of healthcare, including treatment costs and economic burden on patients. Understanding the role of money in accessing diabetes treatments and managing care is essential for evaluating healthcare equity, developing cost-effective therapies, and ensuring that financial constraints do not impede necessary health interventions.
27) Diet:
Diet refers to the structured eating habits or nutritional intake of individuals. For diabetes management, diet is crucial in regulating blood glucose levels and overall health. Research into diet allows identification of effective nutritional interventions and educates patients on healthy eating practices that can positively influence their condition.