Evidence mapPaperPMID 40441739Full record

Observational studyBMJ open diabetes research & care2025

Healthcare utilization and costs in adults with type 2 diabetes treated with first or second-generation basal insulins in England.

Neil Holden, Onyinye Diribe, Karen Palmer, Amar Puttanna, Aymeric Mahieu, Charlie Nicholls, Xiaocong Li Marston, Nick Denholm, Fatemeh Saberi Hosnijeh, Iskandar Idris

Abstract readObservational Study
In one paragraph

Observational study in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Neil HoldenSanofi UK, Reading, UK Neil.Holden@sanofi.com.
Onyinye DiribeSanofi UK, Reading, UK.
Karen PalmerSanofi UK, Reading, UK.
Amar PuttannaSanofi UK, Reading, UK.
Aymeric MahieuSanofi Campus Gentilly, Gentilly, France.
Charlie NichollsSanofi UK, Reading, UK.
Xiaocong Li MarstonHEOR & Market Access, OPEN Health Communications LLP, London, UK.
Nick DenholmHEOR & Market Access, OPEN Health Communications LLP, London, UK.
Fatemeh Saberi HosnijehHEOR & Market Access, OPEN Health Communications LLP, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-7572-9715
Iskandar IdrisCentre of Metabolism, Ageing & Physiology, Nottingham NIHR BRC, University of Nottingham, Nottingham, UK.ORCID http://orcid.org/0000-0002-7548-8288

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe prevalence of people with type 2 diabetes (T2D) on basal insulin (BI) is rising to improve glucose control and minimize complications. However, limited evidence exists regarding the economic impact of second-generation BI analogs compared with first-generation BI in the United Kingdom. RESEARCH DESIGN AND

methodsIn this comparative retrospective, observational study, adults with T2D who initiated treatment with a first-generation BI (eg, glargine 100 U/mL, detemir) and switched to another first-generation or a second-generation BI (glargine 300 U/mL (Gla-300) or degludec) (index date) between 1 July 2014 and 31 March 2021 were analyzed using the Clinical Practice Research Datalink (CPRD) Aurum linked to Hospital Episode Statistics. Subjects were followed from the index date until the end of observation period, deregistration in CPRD or death. Propensity score weighting balanced baseline characteristics and healthcare resource utilization (HCRU) and costs were compared using standardized differences and zero-inflated regression models.

resultsA total of 13 975 people with T2D (mean (SD) age: 62.45 (13.59) years) treated with a first-generation BI who switched to another first-generation BI (n=5654), Gla-300 (n=4737) or degludec (n=3584) were included. Mean (SD) follow-up time was 4.98 (4.27), 1.96 (1.62) and 2.05 (1.92) years for the first-generation BI, Gla-300 and degludec groups, respectively. Overall, people who switched to Gla-300 had significantly lower HCRU. Fewer people in the Gla-300 group received hypoglycemia-related healthcare compared with those in the first-generation BI group (9.1% vs 16.4%, incident rate ratio (IRR)=0.41, p<0.001) and the degludec group (9.2% vs 11.7%, IRR=0.51, p<0.001). During follow-up, diabetes-related and diabetic ketoacidosis-related total direct costs were lower for the Gla-300 group compared with the first-generation BI group by 17% and the degludec group by 60%, respectively.

conclusionsThese findings suggest that Gla-300 may offer clinical and economic benefits by reducing hypoglycemia incidents and lowering healthcare costs compared with first-generation BI.

Indexed as

Diabetes Mellitus, Type 2Health Care CostsHypoglycemic AgentsInsulin, Long-ActingPatient Acceptance of Health CareAdultAgedBlood GlucoseEnglandFemaleFollow-Up StudiesGlycated HemoglobinHumansInsulin GlargineMaleMiddle AgedBlood GlucoseGlycated HemoglobinHypoglycemic Agentsinsulin degludecInsulin GlargineInsulin, Long-ActingDiabetes Mellitus, Type 2Health Care CostsHypoglycemiaInsulin

Identifiers

PMID40441739
PMCPMC12121600

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.