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Inhaled Insulin Gives Better Treatment Satisfaction Than Injected Insulin
NEW YORK (Reuters Health) Jun 26 - Results of a study published in the June issue of Diabetes Care suggest that treatment satisfaction and quality of life are more favorable in diabetic patients who use inhaled insulin compared to those treated with injected insulin.
\"Reaching A1C goals by intensifying the insulin regimen often requires either an insulin pump or a basal/bolus multiple-injection insulin regimen,\" Dr. Marcia A. Testa, of Harvard School of Public Health, Boston, and a colleague write. \"However, use of the pump has been limited by its cost, required technical expertise, and the relative paucity of health care providers trained in its use, and the acceptance of basal/bolus insulin regimens is hindered by the burden of multiple injections.\"
In the current study, the researchers compared the impact of inhaled versus injected insulin on potential mediators of patient adherence of insulin therapy while comparable A1C levels were maintained.
In an open-label, randomized study conducted in 40 U.S. and Canadian centers, the team surveyed treatment satisfaction, quality of life, and adherence barriers at weeks -4, -1, 6, 12, 20, and 24 in adolescents and adults with type 1 diabetes. During a 4-week lead-in, the subjects received premeal regular plus twice-daily NPH insulin. The patients were then randomized to premeal inhaled human insulin plus twice-daily NPH or to continue on the subcutaneous regimen.
Overall, 60 adolescents and 102 adults were assigned to the inhaled regimen and 60 adolescents and 105 adults were assigned to the subcutaneous regimen. The authors report that patients in the inhaled insulin regimen had a greater increase in overall treatment satisfaction than did those in the subcutaneous regimen (13.2 units versus 1.7 units, respectively; p < 0.0001). All 12 satisfaction subscales favored inhaled insulin over subcutaneous insulin. The effects did not vary by age or sex.
Patients in both groups had similar baseline-adjusted end-point A1C levels (7.7% for inhaled regimens and 7.9% for subcutaneous regimens). Despite this, quality-of-life scales of symptoms, mental health, health status, cognitive functioning, and adherence barriers during treatment were more favorable for patients receiving inhaled insulin.
\"It remains to be demonstrated whether these patient-reported outcomes will translate into improved adherence and glycemic control,\" the authors note.
Diabetes Care 2007;30:1399-1405. |
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发表于 2007-6-30 07:23:41