Abstract:
AIMS:To describe insulin therapy in patients with diabetes, to determine treatment costs and to compare costs among treatment regimens. METHODS:This observational study was performed by 734 French pharmacists. Adult patients filling an insulin prescription were invited to participate. Participants provided information on their diabetes history and management. Levels of intensification of insulin therapy were determined by the number of injections in type 1 diabetes mellitus (T1DM) patients, and by the different schemes used in type 2 (T2DM) patients, such as basal/intermediate-acting insulin only, and regimens using both basal and rapid-acting insulin. Costs were evaluated according to official medication costs, nurse visits and glucose monitoring kits. RESULTS:A total of 361 patients with T1DM and 1902 with T2DM were enrolled in the survey. Patients with T1DM more frequently took 1-2 injections per day (46.3% of patients) and used single-dose basal insulin together with ≥1 dose of rapid insulin (43.8%). Patients with T2DM used multiple treatment regimens, with 58 different combinations documented. Most took basal/intermediate insulin only (42.5%) or combinations of basal/intermediate and rapid insulins (52.7%). Mean cost of insulin therapy was €27.4/week for T1DM and €45.4/week for T2DM. In T1DM, insulin was the biggest cost component and increased with the number of injections/day. In T2DM, nurse visits were the most important cost contributors irrespective of treatment regimen. Overall, the cost of insulin therapy increased with the complexity of the insulin schemes. CONCLUSION:Considerable heterogeneity is found in insulin treatment regimens used in everyday diabetes care. Payers should consider the full costs associated with the use of insulin rather than the cost of insulin alone. Treatment algorithms to harmonize insulin therapy should help to improve care, while encouraging patients to self-inject insulin should help to reduce costs.
journal_name
Diabetes Metabjournal_title
Diabetes & metabolismauthors
Charbonnel B,Penfornis A,Varroud-Vial M,Kusnik-Joinville O,Detournay Bdoi
10.1016/j.diabet.2011.10.003subject
Has Abstractpub_date
2012-04-01 00:00:00pages
156-63issue
2eissn
1262-3636issn
1878-1780pii
S1262-3636(11)00203-5journal_volume
38pub_type
杂志文章abstract::Renal remodelling in hyperinsulinic/insulinopenic states is mediated by glucotoxicity, endothelial dysfunction and vascular and nephron collagen turnover. Hypertensive and renal links are renewed by renoprotective interventions of renin-angiotensin. Vasoactive peptide processing and vascular collagen deposition are un...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract:AIM:Cholesterol intake is associated with the risk for type 2 diabetes mellitus, but no previous studies have evaluated its role regarding the risk of gestational diabetes mellitus (GDM). We investigate the relation between cholesterol intake and GDM. METHODS:At screening for GDM, 335 pregnant women were evaluated for...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2006.07.002
更新日期:2007-02-01 00:00:00
abstract::The discoveries of leptin and adiponectin were breakthroughs in the field of metabolic diseases. Adipose cells produce both proteins and release them into the circulation. Leptin acts as a fundamental signal for the brain to modulate food intake as a function of energy status. Loss of leptin function results in obesit...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2007.08.002
更新日期:2008-02-01 00:00:00
abstract:AIM:To study the foveal avascular zone (FAZ) of the central retina in diabetic patients with retinopathy having undergone metabolic evaluation. METHODS:One hundred and ten digital fluorescein angiograms were chosen from our digital image bank after cross matching diabetic patient lists of the ophthalmology and endocri...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70217-3
更新日期:2005-11-01 00:00:00
abstract::Chromium is an essential nutrient involved in the metabolism of glucose, insulin and blood lipids. Suboptimal dietary intake of chromium is associated with increased risk factors associated with diabetes and cardiovascular diseases. Within the past five years, chromium has been shown to improve glucose and related var...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract:INTRODUCTION:While guidelines for detection of silent myocardial and lower limb ischemia are established, data on screening asymptomatic carotid lesions remain scarce. However, such screening would be costly. Since the prevalence of diabetes increases constantly, it is necessary to keep screening costs low by setting u...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/S1262-3636(07)70321-X
更新日期:2006-12-01 00:00:00
abstract::Sodium-glucose cotransporter type 2 (SGLT-2) inhibitors (canagliflozin, dapagliflozin, empagliflozin) are new glucose-lowering agents that exert their therapeutic activity independently of insulin by facilitating glucose excretion through the kidneys. However, this simple renal mechanism that results in sustained gluc...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/S1262-3636(14)72689-8
更新日期:2014-12-01 00:00:00
abstract::Although the pathogenesis of diabetic cardiomyopathy is poorly understood, recent evidence implicates perturbations in cardiac energy metabolism. Whereas mitochondrial fatty acid oxidation is the chief energy source for the normal postnatal mammalian heart, the relative contribution of glucose utilization pathways is ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/S1262-3636(08)70096-X
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Although the management of diabetes mellitus varies according to non medical factors, the influence of socioprofessional category has been not fully studied. This study compared the management of type 2 diabetes mellitus in craftsmen or tradesmen with professionals categories. METHODS:All claims to the Fren...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract::The production of ketone bodies (KB) is dependent on the amount of free fatty acids (FFA) supplied to the liver and on the hepatic metabolic fate of fatty acids and their orientation towards oxidation and ketogenesis or reesterification. In vivo ketogenesis can thus be regulated at the pre-hepatic (lipolysis) or hepat...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract:AIM:Different treatment strategies have been used to manage adolescents with poorly controlled type 1 diabetes. We investigated whether a brief elective hospital admission improves haemoglobin A(1c) (HbA(1c)) over 12 months. METHODS:We studied a retrospective cohort of adolescents with poorly controlled type 1 diabete...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2013.04.003
更新日期:2013-12-01 00:00:00
abstract:AIM:Oxytocin administration to diet-induced obese (DIO) rodents, monkeys and humans decreases body weight and fat mass with concomitant improvements in glucose metabolism. Moreover, several studies show an immunomodulatory role of oxytocin in a number of settings (such as atherosclerosis, injury, sepsis). This study ai...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2017.10.004
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To analyze pulse pressure (PP) as a risk predictor for coronary heart disease (CHD), stroke and cardiovascular disease (CVD; CHD and/or stroke) in type 2 diabetic patients. METHODS:A total of 11,128 female and male type 2 diabetic patients with known baseline PP values and no CVD, aged 50-74 years, were fol...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2009.04.010
更新日期:2009-12-01 00:00:00
abstract:AIMS:Recent evidence suggests an association between persistent organic pollutants (POPs) and type 2 diabetes. In two First Nations communities where wild food is consumed by a large portion of the population, we compared pollutants in plasma between diabetic and non-diabetic individuals, and investigated the strength ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2013.01.006
更新日期:2013-12-01 00:00:00
abstract::Automated closed-loop (CL) insulin therapy has come of age. This major technological advance is expected to significantly improve the quality of care for adults, adolescents and children with type 1 diabetes. To improve access to this innovation for both patients and healthcare professionals (HCPs), and to promote adh...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2020.10.004
更新日期:2020-11-02 00:00:00
abstract:OBJECTIVE:In France, diabetic subjects were not allowed to dive. The principal risk is hypoglycemia during immersion. However scuba diving is allowed in many countries. To follow blood glucose changes, food intake and insulin adjustments in type 1 diabetic patients when diving, and to propose specific guidelines for su...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70180-5
更新日期:2005-04-01 00:00:00
abstract:AIM:To explore if efficacy and safety findings for insulin glargine 300U/mL (Gla-300) versus insulin glargine 100U/mL (Gla-100), observed over 6 months in insulin-naïve people with type 2 diabetes, are maintained after 12 months. METHODS:EDITION 3 was a phase 3a, randomized, multicentre, open-label, parallel-group, tr...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.diabet.2017.04.007
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:The aim of the present study was to investigate insulin secretion, insulin-receptor binding and peripheral insulin sensitivity in subjects with different degrees of obesity. METHODS:36 obese subjects with normal glucose tolerance and different degrees of obesity and 40 healthy normal-weight subjects partici...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70138-6
更新日期:2004-11-01 00:00:00
abstract::The Diabetes and Cardiovascular Disease study group of the Société francophone du diabète (SFD, French Society of Diabetes) in collaboration with the Société française de cardiologie (SFC, French Society of Cardiology) have devised a consensus statement on the care of the hyperglycaemic/diabetic patient during and in ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,实务指引
doi:10.1016/j.diabet.2011.11.003
更新日期:2012-04-01 00:00:00
abstract::Self-monitoring of blood glucose started only fifty years ago. Until then metabolic control was evaluated by means of qualitative urinary blood measure often of poor reliability. Reagent strips were the first semi quantitative tests to monitor blood glucose, and in the late seventies meters were launched on the market...
journal_title:Diabetes & metabolism
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:Tumor necrosis factor alpha (TNFalpha) is expressed primarily in adipocytes and elevated levels of this cytokine have been linked to obesity and insulin resistance. Several studies have shown statistical evidence of linkage between obesity and the chromosomal region encompassing the TNFalpha gene, suggesting...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70104-0
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months o...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,多中心研究
doi:10.1016/j.diabet.2013.12.002
更新日期:2014-04-01 00:00:00
abstract:AIM:The present study investigated the cyclooxygenase (COX) pathway to elucidate any changes that may be involved in the mechanism(s) underlying diabetic fetopathy. METHODS:Diabetes was induced in female rats (n=12) by two successive daily injections of 55 mg/kg streptozotocin, while control animals (n=10) were inject...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2009.06.009
更新日期:2010-02-01 00:00:00
abstract:AIM:Adiponectin is the most abundant adipokine and may play a key role in the interplay between obesity, inflammation, insulin resistance and the metabolic syndrome (MetS). Thus, this large population-based cohort investigated whether adiponectin at baseline and/or a decrease in adiponectin during follow-up is associat...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2016.07.027
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Recently, the association of the natural variants rs1260326 and rs780094 of the glucokinase regulatory protein (GCKR) gene with increased fasting triglycerides and decreased fasting plasma glucose in diabetic adults was reported; the minor alleles were also found to reduce the risk of type 2 diabetes. The pre...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2011.02.003
更新日期:2011-11-01 00:00:00
abstract::Prevalence of diabetes is increasing worldwide in epidemic proportions. Its appropriate clinical management requires a careful etiological diagnosis. Laminopathies recently emerged as clinically heterogeneous genetic disorders due to mutations in lamins or lamin-associated proteins, which are components of the nuclear...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/s1262-3636(07)70227-6
更新日期:2005-12-01 00:00:00
abstract::Since the 1980s, self-monitoring of blood glucose (SMBG) has allowed easier and improved treatment of insulin-dependent diabetes mellitus (IDDM). SMBG has proved efficient in very selected patients and in conditions such as pregnancy, intensive insulin therapy (CSII and optimal bolus regimen), physical exercise and se...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract::Glycohaemoglobin, and particularly haemoglobin A1c(HbA1c), assays have been used for many years to retrospectively evaluate the glycaemic control of diabetic patients. Cut-off values have been established for deciding treatment modifications. The techniques used in the laboratories however exhibit varying quality, and...
journal_title:Diabetes & metabolism
pub_type: 指南,杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:AIMS:The innate immune-receptor nucleotide oligomerization domain (NOD) protein recognizes intracellular bacterial peptidoglycan. Activation of the innate immune system contributes to the development and progression of insulin resistance. The present study aimed to determine the presence of NOD1 and NOD2 in human adipo...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2012.08.001
更新日期:2012-12-01 00:00:00
abstract:AIM:Patients with diabetes have shown lower performance in tests of cognitive function especially those testing memory, executive functions, and psychomotor efficiency. They also have an elevated risk of both vascular dementia and Alzheimer's disease. Cognitive impairment may have consequence on treatment compliance. ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/S1262-3636(10)70475-4
更新日期:2010-10-01 00:00:00