Highlights include how cost-effective insulin reduces hospital visits; prevalence of restrictive lung disease in T2DM patients; and the wonders of self-monitoring for cost of care.
Three new studies in type 2 diabetes mellitus (T2DM) suggest human insulin is as safe and effective as costlier insulin analogs in treating T2DM; breathlessness and conditions of restrictive lung disease (RLD), such as pulmonary fibrosis, may be a late complication of T2DM; and self-monitoring of T2DM reduces follow-up costs by more than half.
Less Expensive Insulin Reduces Hospital Visits. Study sought to compare the rates of hypoglycemia-related ED visits or hospital admissions associated with initiation of long-acting insulin analogs vs human NPH insulin in T2DM patients.
Author's Insights. Study found that among T2DM patients, initiation of a basal insulin analog vs NPH insulin was not associated with a reduced risk of hypoglycemia-related ED visits or hospital admissions and A1c levels decreased similarly in both groups.
For more information: Lipska KJ, Parker MM, Moffet HH, Huang ES, Karter AJ. Association of initiation of basal insulin analogs vs neutral protamine hagedorn insulin with hypoglycemia-related emergency department visits or hospital admissions and with glycemic control in patients with type 2 diabetes. JAMA. 2018;320:53-62.
High Prevalence of RLD in T2DM. Study sought to investigate the incidence of RLD and interstitial lung disease in patients with prediabetes and T2DM.
Author's Insights. Patients with pronounced symptoms and RLD showed fibrosing interstitial lung disease on CT scans and there were differences in the morphological analysis of the lung tissue of those with and without diabetes. Also, patients with diabetes had increased pulmonary fibrosis. The current results and findings from animal studies, suggest a significant connection between restrictive lung diseases and T2DM, leading the researchers to suspect that lung disease is a late consequence of T2DM.
For more information: Kopf S, Groener JB, Kender Z, et al. Breathlessness and restrictive lung disease: An important diabetes-related feature in patients with type 2 diabetes. Respiration. 2018;96:29-40.
Self-monitoring Reduces Cost of Care in T2DM. Study sought to develop a georeferenced cost model to measure healthcare accessibility and T2DM patient travel and time costs.
Author's Insights. Study found that by replacing half of the required follow-up visits with self-measurements and electronic feedback, the annual total costs of A1c monitoring was reduced by nearly 60%. With fewer follow-up visits required, the average annual travel costs of patients was reduced >60% per patient.
For more information: Leminen A, TykkylÃ¤inen M, Laatikainen T. Self-monitoring induced savings on type 2 diabetes patients’ travel and healthcare costs. Int J Med Inform. 2018;115:120-127.