Diabetologie und Stoffwechsel 2019; 14(S 01): S19
DOI: 10.1055/s-0039-1688161
ePoster
Lifestyle und Psychosoziales
Georg Thieme Verlag KG Stuttgart · New York

Patient-Level Predictors of Delay in Insulin Initiation and Periods of Insulin Discontinuation among Adults with Type 2 Diabetes

L Fisher
1   University of California, University of California, San Francisco, United States
,
W Polonsky
2   Behavioral Diabetes Institute, Behavioral Diabetes Institute, San Diego, CA, United States
,
D Hessler
1   University of California, University of California, San Francisco, United States
,
J Ivanova
3   Analysis Group, Inc., Analysis Group, Inc., New York, NY, United States
,
U Desai
3   Analysis Group, Inc., Analysis Group, Inc., New York, NY, United States
,
D Cao
4   Eli Lilly & Company, Eli Lilly & Company, Indianapolis, IN, United States
,
F Snoek
5   Amsterdam University Medical Centers, Amsterdam University Medical Centers, Amsterdam, Netherlands
,
M Perez-Nieves
4   Eli Lilly & Company, Eli Lilly & Company, Indianapolis, IN, United States
,
E Mönnig
6   Lilly Deutschland GmbH, Lilly Deutschland GmbH, Bad Homburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
07 May 2019 (online)

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    Aims:

    To examine whether patient demographics, T2D history and patients' observations of the impact of insulin on family/friends, were associated with delays in initial BI initiation and problematic BI persistence over time.

    Materials and Methods:

    594 T2D adults (from Brazil, Canada, Germany, Japan, Spain, United Kingdom, United States) participated (mean age = 53.3 [SD = 11.3], 56.7% male). Behaviors assessed: immediate initiation when recommended initially vs. delay; and BI interruption (i.e., discontinuation for > 7 days). Factors included: demographics, T2D history, and patients' perceptions of impact of insulin on overall health and mood in insulin-using family/friends.

    Results:

    Delay in beginning BI was (p < 0.05) associated with: short duration of T2D (odds ratio [OR]= 0.95), > 1 severe hypoglycemic episode (OR = 1.87) and interruptions in BI use over time with: younger age (OR = 0.96), higher BMI (OR 25 – 29.9 kg/m2 = 0.50; > 30 kg/m2 = 0.39), prior use of injectables (OR = 0.38), > 1 severe hypoglycemic episode (OR = 2.55), and the belief that prior insulin use in family/friends had led to poorer overall mood over time versus positive effect (OR = 3.79 for no effect and 5.90 for negative effect).

    Conclusions:

    Younger age, previous use of injectables, previous severe hypoglycemic episodes, fewer years with T2D, and perceived experiences of family/friends' BI use are significantly associated with delay in BI initiation or problematic BI persistence over time. HCPs need to consider patients' T2D history, their observations and interpretations of the effects of BI use in others.


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