INHIRIT, India’s one of the largest human insulin registries encompassing 300 Health Care Professionals(HCPs) and 9000 patients with an objective to identify the factors for timely insulin initiation in T2DM patients. A Multicentric, open label, cross sectional survey in assessing the knowledge and attitude among 112 HCPs through e-questionnaire, validated by a panel of experts. The primary objective is to understand the knowledge, attitude and practice of timely insulin initiation whereas adherence and treatment satisfaction are being assessed as secondary objectives.

Results: Key factors identified for timely insulin initiation were patients uncontrolled on existing therapy (OHA) (91.96%), diabetes duration (66.07%) and presence of comorbidities (57.14%). The comorbidities influencing HCPs to initiate timely insulins are CKD (59.71%), foot ulcer (58.93%), and CAD (52.68%). Affordability and similar efficacy were two important reasons for HCPs to prefer human insulins [median (IQR): 70% (60-75)] over to analogues [30% (25-40)] in day to day practice. HCPs opined to initiate insulin as second and third line therapy in 42.5% of their patients. While intensifying from basal supported oral therapy, 91.49% clinicians preferred premixed human insulins over basal-bolus therapy. Major aspects that deter insulin initiation were patient’s factors (86.61%), newer antidiabetic drugs (58.93%), and physician’s inertia (41.96%). Patient support programs such as insulin injection techniques (34.58%), counselling (33.64%) and educational materials (15.89%) etc. were preferred by HCPs while initiating insulins.

Conclusion: Primary analysis of INHIRIT study provides key insights on timely insulin initiation i.e., patients uncontrolled on OADs, duration of diabetes and comorbid conditions. Similarly patient support programs help HCPs to set individualized glycaemic strategy which helps in better health and economic outcomes in their patients.

Disclosure

D. Pawar: Employee; Self; Biocon. S. Bose: Employee; Self; Biocon. S. Jabeen: Employee; Self; Biocon. S. S.: Employee; Self; Biocon.V. Karadi: None.

© 2018 by the American Diabetes Association.
2018
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