Basal-bolus insulin therapy in older patients is challenging due to the complexities of multiple daily injections and the higher risk of adverse consequences associated with hypoglycemia in this population. The purpose of this analysis was to evaluate the clinical outcomes and prevalence of hypoglycemia in patients 65 years of age or older when delivering basal-bolus therapy with a wearable insulin delivery device (V-Go). A retrospective analysis of electronic medical records in 54 patients with T2DM evaluated change in A1C, weight, insulin total daily dose (TDD) and prevalence of hypoglycemia. Baseline mean ± SD characteristics were age 71 ± 4 years (range 65 to 83), A1C 9.5 ± 1.6%, weight 99 ± 20 kg and TDD 64 ± 41 u/day (range 10 to 224) with 81% of patients prescribed insulin and 83% prescribed concomitant anti-hyperglycemic agents. Baseline hypoglycemia documented in 36% of patients. After a mean duration of 5 months of V-Go use, mean ± SD decreases in A1C (-1.5 ± 1.8%; p<0.0001) and TDD (-9 ± 35 u/day; p=0.107) were observed. Change in weight +0.65 kg; p<0.208. Prevalence of overall and severe hypoglycemia was markedly decreased with V-Go. As people with T2DM age, it may become necessary to simplify complex insulin regimens due to a decline in self-management ability while being mindful of risk factors. In this analysis, use of V-Go in an older population proved safe and efficacious.
Disclosure
T. Zeidan: Advisory Panel; Self; Corcept Therapeutics. Research Support; Self; Valeritas, Inc. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Valeritas, Inc. C.C. Nikkel: Employee; Self; Valeritas, Inc. Stock/Shareholder; Self; Valeritas, Inc. E.A. Dziengelewski: Employee; Self; Valeritas, Inc. Stock/Shareholder; Self; Valeritas, Inc.
