INITIATING INSULIN-TREATMENT IN INSULIN-REQUIRING TYPE-2 DIABETIC-PATIENTS - COMPARATIVE EFFICIENCY AND COST OF OUTPATIENT AND INPATIENT MANAGEMENT

Citation
A. Penfornis et L. Millot, INITIATING INSULIN-TREATMENT IN INSULIN-REQUIRING TYPE-2 DIABETIC-PATIENTS - COMPARATIVE EFFICIENCY AND COST OF OUTPATIENT AND INPATIENT MANAGEMENT, DIABETES & METABOLISM, 24(2), 1998, pp. 137-142
Citations number
17
Categorie Soggetti
Endocrynology & Metabolism
Journal title
DIABETES & METABOLISM
ISSN journal
12623636 → ACNP
Volume
24
Issue
2
Year of publication
1998
Pages
137 - 142
Database
ISI
SICI code
0338-1684(1998)24:2<137:IIIITD>2.0.ZU;2-N
Abstract
The main objective of this randomised study was to compare glycaemic c ontrol (as determined by HbAlc levels) in two groups of insulin-requir ing Type 2 diabetic patients three months after initiation of insulin therapy either on an inpatient (group A, n = 58) or outpatient (group B, n = 56) basis. Evaluation of the safety and cost of both methods wa s a secondary objective. Although HbAlc level at inclusion was slightl y but significantly lower in group A than group B (10.17 +/- 0.19% vs. 10.87 +/- 0.22% respectively, P = 0.019), covariance analysis showed equivalent glycaemic control at 3 months in both groups (adjusted mean s with respect to inclusion values: 9.00 +/- 1.14% vs. 9.37 +/- 1.14% respectively; equivalence hypothesis: P = 0.01). A low and similar inc idence of episodes of hypoglycaemia and hyperglycaemia with ketonuria was observed. Clinical tests, paramedical care and the cost of hospita lisation itself resulted in a direct cost of initiating treatment that was more than four times higher in group A than in group B (mean tota l cost per patient: FF 15,231 and FF 3,296 respectively). Insulin-requ iring Type 2 diabetic patients can be efficiently and safely started o n insulin as outpatients, and this approach to initiating insulin ther apy is cost-effective.