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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Endocrine Disorders 1/2015

Geographic patterns in patient demographics and insulin use in 18 countries, a global perspective from the multinational observational study assessing insulin use: understanding the challenges associated with progression of therapy (MOSAIc)

Zeitschrift:
BMC Endocrine Disorders > Ausgabe 1/2015
Autoren:
Jennifer M. Polinski, Seoyoung C. Kim, Dingfeng Jiang, Ahmed Hassoun, William H. Shrank, Xavier Cos, Efraín Rodríguez-Vigil, Shuichi Suzuki, Ikuro Matsuba, John D. Seeger, Wesley Eddings, Gregory Brill, Bradley H. Curtis
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12902-015-0044-z) contains supplementary material, which is available to authorized users.

Competing interests

Funding: This work was funded by a grant to Brigham and Women’s Hospital from Eli Lilly for the MOSAIc study (fund number 2200–107512). The authors retained independent and complete control over the design and implementation of the study, as well as the analyses and writing of the manuscript, the manuscripts contents, and the decision to publish. Eli Lilly reviewed the manuscript, but the final decision to publish and decisions as to what was published were retained by the study authors.
Duality of Interest: Dr. Polinski was an employee at the Division of Pharmacoepidemiology and Pharmacoeconomics when the work was completed and is now an employee of CVS Health. During the time when Dr. Polinski was an employee at the Division of Pharmacoepidemiology and Pharmacoeconomics, she received salary support through her employer for the MOSAIc study. Dr. Kim is supported by the NIH grant K23 AR059677. There are no further disclosures.

Authors’ contributions

Author Contributions: JMP is responsible for the concept and design of the study, the acquisition of data, the analysis and interpretation of data, the drafting the manuscript, and is the guarantor of this work. SCK is responsible for the analysis and interpretation of data, drafting the manuscript, and critical revision of the manuscript. DJ is responsible for the analysis and interpretation of data and critical revision of the manuscript. AH is responsible for analysis and interpretation of data and critical revision of the manuscript. WHS is responsible for analysis and interpretation of data and critical revision of the manuscript. XC is responsible for acquisition of data and critical revision of the manuscript. ER-V is responsible for acquisition of data and critical revision of the manuscript. SS is responsible for concept and design of the study, analysis and interpretation of data, and critical revision of the manuscript. IM is responsible for concept and design of the study, the acquisition of data, the analysis and interpretation of data, and critical revision of the manuscript. JDS is responsible for the concept and design of the study, analysis and interpretation of the data, and critical revision of the manuscript. WE is responsible for analysis and interpretation of data and the drafting the manuscript. GB is responsible for analysis and interpretation of data and critical revision of the manuscript. BHC is responsible for concept and design of the study, the acquisition of data, the analysis and interpretation of data, and critical revision of the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Among patients with type 2 diabetes, insulin intensification to achieve glycemic targets occurs less often than clinically indicated. Barriers to intensification are not well understood. We present patients’ baseline characteristics from MOSAIc, a study investigating patient-, physician-, and healthcare environment-based factors affecting insulin intensification and subsequent health outcomes.

Methods

MOSAIc is a longitudinal, observational study following patients’ diabetes care in 18 countries: United Arab Emirates (UAE), Argentina, Brazil, Canada, China, Germany, India, Israel, Italy, Japan, Mexico, Russia, Saudi Arabia, South Korea, Spain, Turkey, United Kingdom, United States. Eligible patients are age ≥18, have type 2 diabetes, and have used insulin for ≥3 months with/without other antidiabetic medications. Extensive baseline demographic, clinical, and psychosocial data are collected at baseline and regular intervals during the 24-month follow-up. We conducted descriptive analyses of baseline data.

Results

Four thousand three hundred forty one patients met eligibility criteria. Patients received their type 2 diabetes diagnosis 12 ± 8 years prior to baseline visit, yet patients in developing countries were younger than in developed countries (e.g., UAE, 55 ± 10; Germany = 70 ± 10). Saudi Arabians had the highest HbA1c values (9.0 ± 2.2) and Germany (7.5 ± 1.4) among the lowest. Most patients in 5 (28 %) of the 18 countries did not use an oral antidiabetic drug. Over half of patients in fourteen (78 %) countries exclusively used basal insulin; most Indian and Chinese patients exclusively used mixed insulin.

Conclusions

MOSAIc’s baseline data highlight differences in patient characteristics across countries. These patterns, along with physician and healthcare environment differences, may contribute to the likelihood of insulin intensification and subsequent clinical outcomes.
Zusatzmaterial
Additional file 1: Names of Ethics Review Boards granting approval to MOSAIc, by country. (DOCX 23 kb)
12902_2015_44_MOESM1_ESM.docx
Additional file 2: (DOCX 87 kb)
12902_2015_44_MOESM2_ESM.docx
Literatur
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