Background: Insulin Lispro 200 units/ml is a concentrated rapid-acting mealtime insulin (MTI) available as a prefilled, disposable pen (IL200) indicated for adults who require >20 units/day of prandial insulin. In comparison with Insulin Lispro 100 unit/ml prefilled pen, IL200 permits the delivery of an insulin dose in half the injection volume  and a lower glide force . This study aims to understand physicians reasons to prescribe IL200, as well as characterize patients treated with IL200 in Germany.
Methods: Physicians surveyed were diabetologists, endocrinologists or internal medicine specialists selected through screener questions from IQVIAs Primary Intelligence platform. Only physicians treating at least 20 patients per month with IL200 were invited to participate to gain experienced and specialized physicians. The physician survey comprised questions related to physician rationale for prescribing IL200 and patient characteristics.
Results: A total of 98 physicians were included in the survey. The majority were men (75.5%), above 50 years (51.0%), with a mean 18.1 years (SD:7.0) experience treating patients with diabetes (PwD), and mainly working in an office setting (65.3%). Responders reported that an average of 227 PwD were consulted per month, 39.8% of PwD consulted were treated with MTI therapy, and out of these, 52.0% were prescribed IL200. On average, physicians reported that, for patients treated with IL200, 78.6% had Type 2 diabetes, 50.0% were female, 51.9% were aged 2164 years old at diagnosis, and 45.1% had a BMI above or equal 30.0 kg/m2. Physicians reported that 77.9% of patients received an IL200 total daily dose higher than 20 units/day, and 48.3% of patients had an A1c level >7.5%. When asked the rationale for prescribing IL200, physicians rated as very or absolutely important the following objective clinical factors: insulin dose (88.8%); pattern of self-measured glucose levels (80.6%); and A1c level (80.6%). Regarding patient behaviour, the most important reasons for prescribing IL200 were the following patient characteristics: adherence behaviour (88.8%); knowledge about hypoglycaemia (88.8%); motivation to improve lifestyle (80.6%); and desire to reduce insulin injection volume (72.4%).
Conclusions: Physicians are mainly prescribing IL200 to people with T2D that are using more than 20 units of MTI/day. The top reasons of the physicians to prescribe IL200 were the required daily insulin dose, the ability to self-monitor glucose levels, and the desire to achieve better glucose control.
18 - 21 May 2019
European Society of Endocrinology