Japanese Journal of Pharmaceutical and Diabetes
Online ISSN : 2188-5885
Print ISSN : 2187-6967
ISSN-L : 2187-6967
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Original Article
  • A Randomised Triple Crossover Study
    Soichi Takeishi, Hiroki Tsuboi
    2019 Volume 8 Issue 2 Pages 259-267
    Published: December 20, 2019
    Released: January 25, 2020
    JOURNALS RESTRICTED ACCESS

    We compared effect of long-acting insulin during titration period. Thirty patients with type 2 diabetes were randomly allocated to 3 groups. On admission, fasting plasma glucose (FPG) levels were stabilized at 80 mg/dL level with long-acting insulin, during study period. Group 1: FPG levels were stabilized with glargine 300 U/mL (glargine 300); next, patients wore a continuous glucose monitor device (FreeStyle Libre Pro) and then glycaemic variability (GV) was evaluated on days 3 and 4; glargine 300 was switched to degludec on day 5, and GV was evaluated on days 8 and 9; Degludec was switched to glargine 100 U/mL (glargine 100) on day 10, and GV was evaluated on days 13 and 14. Long-acting insulin was administered at 08:00. Group 2: Long-acting insulin was administered in the order of degludec, glargine 100, glargine 300, following the same regimen. Group 3: Long-acting insulin was administered in the order of glargine 100, glargine 300, degludec, following the same regimen. Area over the glucose curve (<70 mg/dL) was significantly lower in patients on glargine 300, degludec, glargine 100, in that order. glargine 300 may be the best long-acting insulin to reduce hypoglycaemia during titration period.

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  • Takako Hoshino, Tadashi Kasahara, Shunya Ikeda
    2019 Volume 8 Issue 2 Pages 268-282
    Published: December 20, 2019
    Released: January 25, 2020
    JOURNALS RESTRICTED ACCESS

    This study clarified the cost-effectiveness of early and short-term intervention with insulin as compared to oral anti-diabetic drugs for patients with type 2 diabetes mellitus in Japan. The lifetime costs and benefits of early intervention with insulin versus oral anti-diabetic drugs for patients with type 2 diabetes were evaluated by cost-effectiveness analysis conducted using the UKPDS outcome Model©. The analysis was performed considering the payers’ perspective in Japanese medical settings. The parameters were obtained from the literature. Future costs and effectiveness were discounted by 2% per year. The expected lifetime costs for male and female diabetics of the insulin treatment group were JPY 3,095,631 (USD 25,927) and JPY 2,801,185 (USD 23,461), respectively, while those for male and female diabetics of the oral antidiabetic drug treatment group were JPY 3,086,926 (USD 25,584) and JPY 2,782,245 (USD 23,302), respectively. The expected life years was prolonged by 0.110 [95% CI: 0.032 to 0.189] and 0.074 [95% CI: 0.017 to 0.132], and the quality-adjusted life years increased by 0.059 [95% CI: 0.002 to 0.204] and 0.087 [95% CI: 0.039 to 0.135] in male and female patients, respectively, treated with insulin compared with OAD. Our results suggest that early and short-term intervention with insulin for type 2 diabetic patients was associated with an almost equivalent expected lifetime cost, prolonged expected life years, and increased the quality-adjusted life years as compared to that with oral antidiabetic drug treatment; early and short-term intervention with insulin was thus more cost-effective as compared to that with oral antidiabetic drugs.

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