Frequency of blood glucose testing among insulin-treated diabetes mellitus patients in the United Kingdom

Abstract

Background:

Through a retrospective database analysis, this study seeks to provide an understanding of the utilization of SMBG by insulin therapy and diabetes type and to estimate healthcare costs of blood glucose monitoring in the UK diabetes population.

Methods:

Data were obtained from the IMS LifeLink Electronic Medical Record-Europe (EMR-EU) Database, a longitudinal database containing anonymized patient records from physician–practice data systems of office-based physicians in the UK. Depending on the insulin types used for type 1 and type 2 diabetes, patients were sub-categorized into one of four insulin regimen groups (basal, bolus, pre-mixed, or basal-bolus). Frequency of blood glucose testing was assessed descriptively throughout the 12-month post-index period, and generalized linear models were used to evaluate the effect of baseline characteristics, including insulin type, on the likelihood of blood glucose test utilization. Healthcare resource utilization and costs for all-cause services were assessed by insulin type.

Results:

This study identified 8322 type 1 and type 2 diabetes patients with two insulin pharmacy records between January 1, 2009 and December 31, 2010. After applying study inclusion and exclusion criteria, a total of 2676 (32.2%) insulin-treated diabetes mellitus patients in the UK were identified, with the number of pharmacy blood glucose test strips averaging 771.1 (median 600). The glucose testing frequency was lowest among basal-only insulin patients and pre-mixed insulin patients (mean = 576.2 [median = 450] and mean = 599.5 [median = 500], respectively; non-significantly different) compared to other insulin types.

Conclusion:

Although the data did not capture the glucose frequency comprehensively, it varied significantly by insulin types, and was higher than what is recommended in the guidelines for patients with type 2 diabetes.

Keywords::

• Blood glucose
• Cost
• Diabetes
• Insulin
• Management
• Self-monitoring of blood glucose
• Testing

Transparency

Declaration of funding

Funding for this study was provided by Novo Nordisk.

Declaration of financial/other relationships

IMS Consulting received consulting fees from Novo Nordisk for this study. Dr Lee has disclosed that he is an employee of IMS Consulting Group; and Dr Smith has disclosed that she was an employee of IMS Consulting Group during the time this study was conducted and submitted for publication. Drs Wolden and Chubb are employees of Novo Nordisk. JME Peer Reviewers on this manuscript have no relevant financial relationships to disclose.

Acknowledgments

The authors wish to acknowledge from IMS Consulting Group the assistance of Katharine Coyle in drafting and formatting some parts of the manuscript and Jennifer Korsnes for data analysis.