Abdul Jabbar1, Khalifa Abdallah2, Ahmed Hassoun3, Rachid Malek4, Cagri Senyucel5, Erik Spaepen6, Tamas Treuer7, Indranil Bhattacharya8. 1. Diabetes and Endocrine Unit, Department of Endocrinology, Medcare Hospital, Jumeira, Dubai, United Arab Emirates. Electronic address: haj1960@gmail.com. 2. Diabetes and Metabolism Unit, Department of Internal Medicine, Alexandria University, Alexandria, Egypt. 3. Dubai Diabetes Center, Dubai Health Authority, Dubai, United Arab Emirates. 4. Department of Internal Medicine, CHU Setif, Algeria. 5. Eli Lilly and Company, Indianapolis, IN, USA. 6. Eli Lilly and Company, Bad Homburg, Germany. 7. Eli Lilly and Company, Budapest, Hungary. 8. Eli Lilly and Company, Gurgaon, India.
Abstract
AIM: Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region. METHODS: 1192 patients aged ≥18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants. RESULTS: 67.6% patients had HbA1c ≥9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on ≥2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels of <7.5%. The proportion of patients completely satisfied with their insulin treatment, and the QoL increased over the study course. CONCLUSION: Results support that timely initiation and early intensification of insulin therapy are necessary in the region to achieve adequate and timely glycemic control and to prevent diabetic complications.
AIM: Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region. METHODS: 1192 patients aged ≥18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants. RESULTS: 67.6% patients had HbA1c ≥9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on ≥2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels of <7.5%. The proportion of patients completely satisfied with their insulin treatment, and the QoL increased over the study course. CONCLUSION: Results support that timely initiation and early intensification of insulin therapy are necessary in the region to achieve adequate and timely glycemic control and to prevent diabetic complications.
Authors: Laura Piombo; Gianluca Nicolella; Giulia Barbarossa; Claudio Tubili; Mayme Mary Pandolfo; Miriam Castaldo; Gianfranco Costanzo; Concetta Mirisola; Andrea Cavani Journal: Int J Environ Res Public Health Date: 2020-12-01 Impact factor: 3.390