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One very clear difference in resource use patterns after initiation of injectable therapy was an initial increase in HCP visits in the insulin cohort but not in the exenatide bid cohort.
Because the fear of injection-related pain is a real barrier to successful initiation of injectable therapy, this section describes how various needle attributes may influence injection pain, including length, gauge (diameter), bevel design, and other enhancements that reduce needle wall size (microtapering).
40 At subsequent clinic visits after the initiation of injectable therapy, patients can be reassessed for their injection technique, with education and correction provided by a member of the health care team as needed.
41– 43 At 12 months after initiation of injectable therapy, 24.3% and 28.9% of the initiators and persisters population, respectively, from the exenatide BID cohort, and about 10% of both populations from the insulin cohort, met the clinically relevant composite endpoint suggested by Zinman and colleagues 44 of HbA1c < 7%, no weight gain (≤1 kg change), and no hypoglycemia.
Barriers to the initiation of injectable therapy originate from both patients and practitioners.
CHOICE measured PROs at, and during the 24 months following, initiation of injectable therapy with exenatide BID or insulin.
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The primary endpoint of CHOICE was the time from the initiation of initial injectable regimen (exenatide BID or insulin) to significant treatment change (see Mathieu et al. [ 22] for definitions).
Clinical data were collected at initiation of first injectable therapy and after approximately 3, 6, and 12 months.
About 30% of patients in CHOICE changed treatment in the first 12 months after initiation of first injectable therapy (exenatide BID or insulin).
Clinical and resource use data were collected at initiation of first injectable therapy (exenatide bid or insulin) and at regular intervals for 24 months.
Using pilot data from the Initiation of New Injectable Treatment Introduced after Anti-diabetic Therapy with Oral-only Regimens study, real-world treatment patterns among T2DM patients initiating injectable therapy with insulin glargine or liraglutide were assessed.
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