Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.

<h4>Background</h4>Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was condu...

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Main Authors: Hedyeh Ebrahimi, Farhad Pishgar, Moein Yoosefi, Sedighe Moradi, Nazila Rezaei, Shirin Djalalinia, Mitra Modirian, Niloofar Peykari, Shohreh Naderimagham, Rosa Haghshenas, Saral Rahimi, Hamidreza Jamshidi, Alireza Esteghamati, Bagher Larijani, Farshad Farzadfar
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0221462
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spelling doaj-21d92b8c7e3c46549e061b8c34cf6b9d2021-03-04T10:25:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01148e022146210.1371/journal.pone.0221462Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.Hedyeh EbrahimiFarhad PishgarMoein YoosefiSedighe MoradiNazila RezaeiShirin DjalaliniaMitra ModirianNiloofar PeykariShohreh NaderimaghamRosa HaghshenasSaral RahimiHamidreza JamshidiAlireza EsteghamatiBagher LarijaniFarshad Farzadfar<h4>Background</h4>Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology.<h4>Methods</h4>In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling.<h4>Results</h4>There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels.<h4>Conclusion</h4>Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.https://doi.org/10.1371/journal.pone.0221462
collection DOAJ
language English
format Article
sources DOAJ
author Hedyeh Ebrahimi
Farhad Pishgar
Moein Yoosefi
Sedighe Moradi
Nazila Rezaei
Shirin Djalalinia
Mitra Modirian
Niloofar Peykari
Shohreh Naderimagham
Rosa Haghshenas
Saral Rahimi
Hamidreza Jamshidi
Alireza Esteghamati
Bagher Larijani
Farshad Farzadfar
spellingShingle Hedyeh Ebrahimi
Farhad Pishgar
Moein Yoosefi
Sedighe Moradi
Nazila Rezaei
Shirin Djalalinia
Mitra Modirian
Niloofar Peykari
Shohreh Naderimagham
Rosa Haghshenas
Saral Rahimi
Hamidreza Jamshidi
Alireza Esteghamati
Bagher Larijani
Farshad Farzadfar
Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
PLoS ONE
author_facet Hedyeh Ebrahimi
Farhad Pishgar
Moein Yoosefi
Sedighe Moradi
Nazila Rezaei
Shirin Djalalinia
Mitra Modirian
Niloofar Peykari
Shohreh Naderimagham
Rosa Haghshenas
Saral Rahimi
Hamidreza Jamshidi
Alireza Esteghamati
Bagher Larijani
Farshad Farzadfar
author_sort Hedyeh Ebrahimi
title Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
title_short Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
title_full Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
title_fullStr Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
title_full_unstemmed Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.
title_sort insulin pen use and diabetes treatment goals: a study from iran steps 2016 survey.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2019-01-01
description <h4>Background</h4>Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology.<h4>Methods</h4>In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling.<h4>Results</h4>There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels.<h4>Conclusion</h4>Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.
url https://doi.org/10.1371/journal.pone.0221462
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