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Treatment satisfaction and quality of life with insulin glargine plus insulin lispro compared with NPH insulin plus unmodified human insulin in individuals with type 1 diabetes

Lookup NU author(s): Dr Simon Ashwell, Emeritus Professor Philip Home


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OBJECTIVE - The purpose of this study was to compare quality of life (QoL) and treatment satisfaction using insulin glargine plus insulin lispro with that using NPH insulin plus unmodified human insulin in adults with type 1 diabetes managed with multiple injection regimens. RESEARCH DESIGN AND METHODS - As part of a 32-week, five-center, two-way crossover study in 56 individuals with type 1 diabetes randomized to evening insulin glargine plus mealtime insulin lispro or to NPH insulin (once or twice daily) plus mealtime unmodified human insulin, the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Audit of Diabetes Dependent Quality of Life questionnaire were completed at baseline and at weeks 16 and 32, with additional interim DTSQ measurements. RESULTS - For all patients combined, the mean baseline present QoL score was 1.3, reflecting "good" QoL. Present QoL improved with glargine + lispro but did not change with NPH + human insulin (1.6 +/- 0.1 [mean +/- SEM] vs. 1.3 +/- 0.1, difference 0.3 [95% CI 0.1-0.6]; P = 0.014). Baseline mean average weighted impact score (AWI) of diabetes on QoL was -1.8, indicating a negative impact of diabetes on QoL. The AWI score at end point improved significantly with glargine + lispro but changed little with NPH + human insulin (-1.4 +/- 0.1 vs. -1.7 +/- 0.1, 0.3 [0.0-0.6]; P = 0.033). Treatment satisfaction (DTSQ 36-0 scale score) at end point was markedly greater with glargine plus lispro compared with that for NPH plus human insulin (32.2 +/- 3.4 vs. 23.9 +/- 7.2, 8.6 [6.5-10.6]; P

Publication metadata

Author(s): Ashwell SG, Bradley C, Stephens JW, Witthaus E, Home PD

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2008

Volume: 31

Issue: 6

Pages: 1112-1117

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association


DOI: 10.2337/dc07-1183


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