AACE ePoster Library

EVALUATING THE EFFECT OF V-GO® THERAPY IN SUB-OPTIMALLY CONTROLLED PATIENTS WITH DIABETES – A RETROSPECTIVE COHORT ANALYSIS IN A LARGE SPECIALIZED DIABETES SYSTEM
AACE ePoster Library. Lajara R. 05/13/15; 97795; 273
Dr. Rosemarie Lajara
Dr. Rosemarie Lajara
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Abstract
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Objective: The purpose of this retrospective analysis was to evaluate the glycemic effect of switching to V-Go Disposable Insulin Delivery Device (V-Go) in patients with Diabetes Mellitus (DM) sub-optimally controlled on previous therapeutic regimens.

Methods: An electronic medical records database from a large specialized diabetes system was queried to identify patients exceeding glycemic targets (HbA1c > 7.0) on multiple daily insulin injections (MDI), basal insulin therapy (Basal), or naïve to insulin (Naïve) at baseline, changed to V-Go between April 2013 and May 2014. HbA1c, weight, insulin dosing, and reported hypoglycemia were collected at baseline and at each followup office visit with an HbA1c result.

Results or Case Presentation: One hundred fifty three patients had a followup visit (FV1) with a documented HbA1c, and to date, 102 patients had a second HbA1c result (FV2) at the time of these analyses. The mean age was 52 yrs, weight 96 kg (212 lbs), and duration of DM 14 yrs. Eighty six patients were on MDI, 45 on Basal and 22 were Naïve at baseline. Mean exposure to V-Go therapy was 98 days for FV1 and 180 days for FV2. Mean baseline HbA1c levels were 9.7% for the total population and 9.4%, 9.6%, and 11.2% for the MDI, Basal and Naïve cohorts, respectively. Significant HbA1c reductions at both FV1 and FV2 were observed for all patients and all cohorts (p<0.0001). Mean changes [95% CI] from baseline for FV1 and FV2 were as
follows: total population (1.7 [2.0, 1.4], 1.8 [2.1, 1.5]), MDI cohort (1.2 [1.5, 0.89], 1.2 [1.6, 0.86]), Basal cohort (1.9 [2.4, 1.5] 2.3 [2.8, 1.7]), and Naïve cohort (3.1 [4.0, 2.3], 3.3 [4.2, 2.4]), respectively.

Patients previously on MDI therapy experienced a 31% to 48% reduction from baseline insulin total daily dose at FV1 on V-Go which was maintained at FV2.
A reduction in fasting plasma glucose (192 to 146 mg/dl) was observed in the Basal cohort despite a 33% to 41% reduction from mean baseline daily basal insulin dose at FV1 on V-Go which was maintained at FV2.
The total population experienced a mean increase in weight of 1.44 kg (p=0.055) at FV1 which was maintained at FV2.
Despite robust improvements in glucose control the overall incidence of reported hypoglycemia was similar to baseline at both visits.

Discussion: Patients with sub-optimal DM control switched to V-Go achieved significant HbA1c improvements with reductions in total daily insulin requirements by most. Patients on previous Basal insulin regimens and Naïve to insulin experienced the greatest reductions in HbA1c.

Conclusion: V-Go is both safe and effective in patients with uncontrolled DM requiring insulin therapy. V-Go was efficacious in patients with marked hyperglycemia and previously naïve to insulin therapy.
Objective: The purpose of this retrospective analysis was to evaluate the glycemic effect of switching to V-Go Disposable Insulin Delivery Device (V-Go) in patients with Diabetes Mellitus (DM) sub-optimally controlled on previous therapeutic regimens.

Methods: An electronic medical records database from a large specialized diabetes system was queried to identify patients exceeding glycemic targets (HbA1c > 7.0) on multiple daily insulin injections (MDI), basal insulin therapy (Basal), or naïve to insulin (Naïve) at baseline, changed to V-Go between April 2013 and May 2014. HbA1c, weight, insulin dosing, and reported hypoglycemia were collected at baseline and at each followup office visit with an HbA1c result.

Results or Case Presentation: One hundred fifty three patients had a followup visit (FV1) with a documented HbA1c, and to date, 102 patients had a second HbA1c result (FV2) at the time of these analyses. The mean age was 52 yrs, weight 96 kg (212 lbs), and duration of DM 14 yrs. Eighty six patients were on MDI, 45 on Basal and 22 were Naïve at baseline. Mean exposure to V-Go therapy was 98 days for FV1 and 180 days for FV2. Mean baseline HbA1c levels were 9.7% for the total population and 9.4%, 9.6%, and 11.2% for the MDI, Basal and Naïve cohorts, respectively. Significant HbA1c reductions at both FV1 and FV2 were observed for all patients and all cohorts (p<0.0001). Mean changes [95% CI] from baseline for FV1 and FV2 were as
follows: total population (1.7 [2.0, 1.4], 1.8 [2.1, 1.5]), MDI cohort (1.2 [1.5, 0.89], 1.2 [1.6, 0.86]), Basal cohort (1.9 [2.4, 1.5] 2.3 [2.8, 1.7]), and Naïve cohort (3.1 [4.0, 2.3], 3.3 [4.2, 2.4]), respectively.

Patients previously on MDI therapy experienced a 31% to 48% reduction from baseline insulin total daily dose at FV1 on V-Go which was maintained at FV2.
A reduction in fasting plasma glucose (192 to 146 mg/dl) was observed in the Basal cohort despite a 33% to 41% reduction from mean baseline daily basal insulin dose at FV1 on V-Go which was maintained at FV2.
The total population experienced a mean increase in weight of 1.44 kg (p=0.055) at FV1 which was maintained at FV2.
Despite robust improvements in glucose control the overall incidence of reported hypoglycemia was similar to baseline at both visits.

Discussion: Patients with sub-optimal DM control switched to V-Go achieved significant HbA1c improvements with reductions in total daily insulin requirements by most. Patients on previous Basal insulin regimens and Naïve to insulin experienced the greatest reductions in HbA1c.

Conclusion: V-Go is both safe and effective in patients with uncontrolled DM requiring insulin therapy. V-Go was efficacious in patients with marked hyperglycemia and previously naïve to insulin therapy.

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