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Reasons for Discontinuation of Insulin Therapy—Results from the International Diabetes Management Practices Study (IDMPS)

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Adherence to insulin therapy is often suboptimal. Understanding patients’ perspectives on drug adherence is essential for identification of barriers to therapy. The IDMPS is a global observational survey on the… Click to show full abstract

Adherence to insulin therapy is often suboptimal. Understanding patients’ perspectives on drug adherence is essential for identification of barriers to therapy. The IDMPS is a global observational survey on the management of people with type 1 (T1D) and type 2 (T2D) diabetes in the developing world. In 2016-2017, participants were enrolled from 24 countries in the Middle East, South Asia, Eurasia, and Africa.In people with T1D (N=2000), 14% (273/1955) discontinued insulin for 1 month (median), without physician indication. The main reasons given were impact on social life, cost, fear of hypoglycemia, and lack of support (Table 1). In people with T2D (N=2595), insulin discontinuation for ≥2 months (median), without physician indication, was reported by 13.4% and 13.8% of people treated with insulin alone (n=642) or with an oral antihyperglycemic drug + insulin (n=1895), respectively. The most common reasons for discontinuation included impact on social life, fear of hypoglycemia, lack of support, and cost. The pattern of insulin (eg, a definitive or temporary stop, or missed injection(s)) was not documented. People with T1D and T2D share similar concerns regarding therapy. This calls for a multi-pronged strategy including patient education and access to therapy to improve treatment adherence and optimize outcomes. Disclosure P. Aschner: Other Relationship; Self; Sanofi. J.J. Gagliardino: Other Relationship; Self; Sanofi. H.M. Ilkova: Advisory Panel; Self; Abbott, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S, Boehringer Ingelheim GmbH, Servier, Merck Sharp & Dohme Corp.. Speaker9s Bureau; Self; AstraZeneca. Advisory Panel; Self; Medtronic, Roche Diabetes Care Health and Digital Solutions, Bilim Ilac. F.J. Lavalle-Gonzalez: Advisory Panel; Self; Sanofi. Speaker9s Bureau; Self; Sanofi. Research Support; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker9s Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; AstraZeneca. Speaker9s Bureau; Self; AstraZeneca. Research Support; Self; AstraZeneca. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker9s Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Speaker9s Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Abbott. Speaker9s Bureau; Self; Abbott.A. Ramachandran: None. G. Kaddaha: Other Relationship; Self; Sanofi. J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker9s Bureau; Self; Novo Nordisk A/S, Sanofi, Servier.M.V. Shestakova: None. J. Chantelot: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.

Keywords: advisory panel; speaker9s bureau; self; panel self; self sanofi

Journal Title: Diabetes
Year Published: 2018

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