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. 2021 Jun;30(6):1629-1640.
doi: 10.1007/s11136-020-02753-6. Epub 2021 Feb 7.

Quality of life in patients with type 2 diabetes after switching to insulin degludec: results from a cross-sectional survey

Chioma Uzoigwe  1 , Michael Radin  2 , Carol M Hamersky  2 , Mitch DeKoven  3 , Cassie Holt  4 , Swapna Karkare  5 , William H Polonsky  6   7
Affiliations

Quality of life in patients with type 2 diabetes after switching to insulin degludec: results from a cross-sectional survey

Chioma Uzoigwe et al. Qual Life Res. 2021 Jun.

Abstract

Purpose: Five quality of life (QoL) domains are particularly important to patients with type 2 diabetes (T2D) using basal insulin-sense of physical well-being, sense of safety regarding hypoglycemia, sense of diabetes as burdensome, feelings of freedom and flexibility, and sleep quality.

Methods: An online survey assessed these QoL domains in adult patients with T2D in the USA who had switched from a previous basal insulin to insulin degludec (IDeg): modified versions of the World Health Organization (Five) Well-Being Index (WHO-5), Hypoglycemia Attitudes and Behavior Scale (HABS; confidence and anxiety subscales only), and Diabetes Distress Scale (DDS; emotional burden and regimen-related distress subscales only); three items assessing feelings of freedom and flexibility; and one item assessing sleep quality (hours of restful sleep). Patients rated each item for their previous basal insulin and currently while using IDeg. Correlations between sleep quality and the other QoL scales were also assessed.

Results: In total, 152 patients completed the survey and were included in the study sample. Patients reported significantly improved scores while using IDeg on all WHO-5, DDS, HABS, feelings of freedom and flexibility item scores, and total raw/mean subscale scores (P < 0.0001). Patients also reported a significantly greater number of hours of restful sleep [mean (SD) 6.6 (2.0) vs. 5.5 (1.8); P < 0.0001]. Better sleep quality statistically significantly correlated with improved QoL in all other domains assessed.

Conclusions: Treatment with IDeg after switching from a previous basal insulin was associated with statistically significant improvements in all QoL domains assessed.

Keywords: Basal insulin; Hypoglycemia; Insulin degludec; Insulin glargine; Quality of life; Type 2 diabetes.

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Conflict of interest statement

Chioma Uzoigwe, Michael Radin, and Carol M. Hamersky are employed by Novo Nordisk, Inc., the study sponsor. Mitch DeKoven and Swapna Karkare are employed by IQVIA, which received funding from Novo Nordisk, Inc. for work performed on this study under a contract between IQVIA and Novo Nordisk, Inc. Cassie Holt was employed by IQVIA when the study was conducted; she is now employed by Novo Nordisk, Inc. William H. Polonsky served as a consultant and has received consultant fees from Novo Nordisk. William H. Polonsky has also served as a consultant for Sanofi, and Eli Lilly and Company.

Figures

Fig. 1
Fig. 1
WHO-5 item and total raw scores (N = 152). Higher scores indicate better QoL. Total raw score is the sum of the 5-item scores. *P < 0.0001 for score while using IDeg vs. score while using previous basal insulin. IDeg insulin degludec, QoL quality of life, SD standard deviation, WHO-5 World Health Organization (Five) Well-Being Index
Fig. 2
Fig. 2
HABS item and mean subscale scores (N = 152). a On the confidence subscale, higher scores indicate better QoL (i.e., greater confidence). b On the anxiety subscale, lower scores indicate better quality of life (i.e., less anxiety). * P < 0.0001 for score while using IDeg vs. score while using previous basal insulin. HABS Hypoglycemia Attitudes and Behavior Scale, IDeg insulin degludec, QoL quality of life, SD standard deviation
Fig. 3
Fig. 3
DDS item and mean subscale scores (N = 152). On both the emotional burden subscale (a) and the regimen-related distress subscale (b), lower scores indicate better QoL (i.e., less burden and lower distress). * P < 0.0001 for score while using IDeg vs. score while using previous basal insulin. DDS Diabetes Distress Scale, IDeg insulin degludec, QoL quality of life, SD standard deviation
Fig. 4
Fig. 4
Feelings of freedom and flexibility: item and total scores (N = 152). Higher scores indicate better QoL. * P < 0.0001 for score while using IDeg vs. score while using previous basal insulin. IDeg insulin degludec, QoL quality of life, SD standard deviation
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