Impact Of Insulin Containing Regimen Vs Triple Oral Hypoglycaemic Agent Therapy On Health-Related Quality Of Life, Economic, And Clinical Outcomes In Poorly Controlled Type 2 Diabetes Outpatients In Yogyakarta
Loading...
Date
2010-12
Authors
Andayani, Tri Murti
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Type 2 Diabetes Mellitus (DM) is a progressive disease, and blood glucose control finally will get poorer because the function of pancreatic beta cells will decrease. Monotherapy with oral antidiabetics will not be effective for long so it is followed by two to three oral antidiabetics as combination therapy, and finally, type 2 DM patients will need exogenous insulin therapy. This research compared the addition and switching of therapy to insulin with triple oral therapy measuring three outcome parameters, i.e., clinical, humanistic and economic outcomes. This research applied cohort study designs by conducting six-month observations on the poor blood-glucose-control patients in Dr Sardjito Hospital, Yogyakarta, Indonesia. The research subjects were the patients who were willing to change the therapy to insulin (Group 1) and the patients who refused to use insulin and kept on using therapy combination with sulfonylurea, metformin, and acarbose (Group 2). The measurement of effectiveness was conducted by calculating the HbA1c, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) levels, blood pressure and lipid profile of each therapy group at baseline, third month and sixth month. The measurement of the differences of the quality of life values of the patients was conducted by counting the average of the Diabetes Quality of Life Clinical Trial Questionnaire scores of each therapy group. Cost-effectiveness analysis was performed from the hospital perspective by comparing direct medical costs during the six month period and the effectiveness of the therapy which was measured based on the percentage of patients who achieved the glycaemic target. The results indicates that patients who switched the therapy to insulin were more effective in controlling blood glucose levels than triple oral therapy. However, hypoglycaemic incidents were 36.36% in group 1, and 28.57% in group 2. A higher incidence of gastrointestinal side effects occurred in group 2 (67.35%) than in group 1 (18.18%).
Description
Keywords
Addition and switching of therapy to insulin , with triple oral therapy measuring three outcome parameters