Post-Basal Insulin Intensification and Healthcare Resource Use in Type 2 Diabetes: A Web-Based Physician Survey in the United States and United Kingdom

Abstract

Introduction: Currently, there is limited knowledge of the healthcare resources and time needed to intensify patients with type 2 diabetes (T2D) treated with basal insulin to more complex treatment regimens. The purpose of the study was to investigate physicians’ perspectives on the time and healthcare resources required for post-basal insulin intensification to basal–bolus and to basal in combination with a glucagon-like peptide-1 receptor agonist (GLP-1) regimens. The study also examined referrals to specialists for intensification and patient challenges with intensification. Methods: A web-based survey of physicians was conducted in the United Kingdom (UK) and the United States (USA). Results: A total of 458 physicians completed the survey, including general practitioners (58.5%) and specialists (endocrinologists/diabetologists; 41.5%). On average, 7.0 healthcare provider (HCP) visits (SD 3.7) over 30.1 weeks (SD 17.4) were required to intensify to a basal–bolus regimen, while 5.7 HCP visits (SD 3.8) over 23.5 weeks (SD 15.2) were needed to intensify to basal insulin in combination with GLP-1. Referral to a specialist for intensification required on average an additional 8 weeks of wait time before intensification. Physicians reported that the complexity of the basal–bolus regimen and frequent injections were key challenges for T2D patients intensifying to basal–bolus, while frequent injections and side effects were key challenges for those intensifying with GLP-1. Conclusion: Less complex regimens for intensification following basal insulin may help reduce the time and healthcare resources required for intensification and address some of the challenges T2D patients face when intensifying to basal–bolus or basal with GLP-1. Funding: Novo Nordisk, A/S.