Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens

Abstract EN

We examined the real-world utilization and persistence of rapid acting insulin (RAI) in elderly patients with type 2 diabetes who added RAI to their drug (OAD) regimen.

Insulin-naïve patients aged ≥65 years, with ≥1 OAD prescription during the baseline period, who were continuously enrolled in the US Humana Medicare Advantage insurance plan for 18 months and initiated RAI were included.

Among patients with ≥2 RAI prescriptions (RAIp), persistence during the 12-month follow-up was assessed.

Multivariate logistic regression analyses identified factors affecting RAI use and persistence.

Of 3734 patients adding RAI to their OAD regimen, 2334 (62.5%) had a RAIp during follow-up.

Factors associated with RAIp included using ≤2 OADs; cognitive impairment, basal insulin use during follow-up; and higher RAI out-of-pocket costs ( $ 36 to < $ 56 versus $ 0 to $ 6.30).

Patients were less likely to persist with RAI when on ≤2 OADs versus ≥3 OADs and when having higher RAI out-of-pocket costs ( $ 36 to < $ 56 versus $ 0 to $ 6.30) and more likely to persist when they had cognitive impairment and basal insulin use during follow-up.

Real-world persistence of RAI in insulin-naïve elderly patients with type 2 diabetes was very poor when RAI was added to an OAD regimen.