A Three-Step Data-Driven Methodology to Assess Adherence to Basal Insulin Therapy in Patients With Insulin-Treated Type 2 Diabetes.

Background: While health care providers (HCPs) are generally aware of the challenges concerning insulin adherence in adults with insulin-treated type 2 diabetes (T2D), data guiding identification of insulin nonadherence and understanding of injection patterns have been limited. Hence, the aim of this study was to examine detailed injection data and provide methods for assessing different aspects of basal insulin adherence.
Method: Basal insulin data recorded by a connected insulin pen and prescribed doses were collected from 103 insulin-treated patients (aged ≥18 years) with T2D from an ongoing clinical trial (NCT04981808). We categorized the data and analyzed distributions of correct doses, increased doses, reduced doses, and missed doses to quantify adherence. We developed a three-step model evaluating three aspects of adherence (overall adherence, adherence distribution, and dose deviation) offering HCPs a comprehensive assessment approach.
Results: We used data from a connected insulin pen to exemplify the use of the three-step model to evaluate overall, adherence, adherence distribution, and dose deviation using patient cases.
Conclusion: The methodology provides HCPs with detailed access to previously limited clinical data on insulin administration, making it possible to identify specific nonadherence behavior which will guide patient-HCP discussions and potentially provide valuable insights for tailoring the most appropriate forms of support.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MHJ is an employee of, and holds stock in, Novo Nordisk A/S and PV is head of research at Steno Diabetes Center North Denmark funded by an unrestricted grant from the Novo Nordisk Foundation. Apart from that, we declare that no conflicts of interest are associated with this publication and that Novo Nordisk A/S did not influence the research or its presentation.