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Kiiskinen U, Matthaei S, Reaney M, Mathieu C, Ostenson CG, Krarup T, Theodorakis M, Kiljański J, Salaun-Martin C, Sapin H, Guerci B. Resource use and costs of exenatide bid or insulin in clinical practice: the European CHOICE study. CLINICOECONOMICS AND OUTCOMES RESEARCH 2013; 5:355-67. [PMID: 23874113 PMCID: PMC3713896 DOI: 10.2147/ceor.s44060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Purpose CHOICE (CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy) assessed patterns of exenatide bid and initial insulin therapy usage in clinical practice in six European countries and evaluated outcomes during the study. Methods CHOICE was a 24-month, prospective, noninterventional observational study. Clinical and resource use data were collected at initiation of first injectable therapy (exenatide bid or insulin) and at regular intervals for 24 months. Costs were evaluated from the national health care system perspective at 2009 prices. Results A total of 2515 patients were recruited. At the 24-month analysis, significant treatment change had occurred during the study in 42.2% of 1114 eligible patients in the exenatide bid cohort and 36.0% of 1274 eligible patients in the insulin cohort. Improvements in glycemic control were observed over the course of the study in both cohorts (P < 0.001 for both), but mean weight was reduced in the exenatide bid cohort (P < 0.001) and increased in the insulin cohort (P < 0.001) by 24 months. Across all countries, total per patient health care costs for the 24 months post baseline were €3997.9 in the exenatide bid cohort and €3265.5 in the insulin cohort (€1791.9 versus €2465.5 due to costs other than those of injectable therapy). When baseline direct cost and patients’ and disease characteristics were controlled for, mean direct costs differed by country (P < 0.0001), irrespective of treatment initiated, and the mean cost difference between treatments varied by country (P < 0.0001). Conclusion Much of the higher mean cost of exenatide bid, compared with insulin, therapy was compensated for by lower mean costs of other health service utilization. Costs associated with exenatide bid or insulin initiation varied across countries, highlighting the need to avoid generalization of resource use and cost implications of a particular therapy when estimated in specific country settings.
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Thiery J, Luppa P, Koschinsky T, Matthaei S. Anforderungen an die Messqualität und Qualitätssicherung (QS) von Point-of-Care-Testing(POCT)-Blutglukose-Messsystemen, die für das Screening und die Diagnose eines Gestationsdiabetes mellitus (GDM) gemäß der GDM-Leitlinie der Deutschen Diabetes-Gesellschaft (DDG) geeignet sind. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1335716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Landgraf R, Kellerer M, Fach E, Gallwitz B, Hamann A, Joost H, Klein H, Müller-Wieland D, Nauck M, Reuter H, Schreiber S, Siegel E, Matthaei S. Praxisempfehlungen DDG/DGIM. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1335297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Östenson CG, Matthaei S, Reaney M, Krarup T, Guerci B, Kiljanski J, Salaun-Martin C, Sapin H, Bruhn D, Mathieu C, Theodorakis M. Treatment outcomes after initiation of exenatide twice daily or insulin in clinical practice: 12-month results from CHOICE in six European countries. Diabetes Metab Syndr Obes 2013; 6:171-85. [PMID: 23667315 PMCID: PMC3650573 DOI: 10.2147/dmso.s41827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy (CHOICE) study assessed time to, and reasons for, significant treatment change after patients with type 2 diabetes (T2DM) initiated their first injectable glucose-lowering therapy (exenatide twice daily [BID] or insulin) in routine clinical practice, and these patients' clinical outcomes, in six European countries. This paper reports interim data from the first 12 months of the study. RESEARCH DESIGN AND METHODS CHOICE (NCT00635492) is a prospective, noninterventional, observational study. Clinical data were collected at initiation of first injectable therapy and after approximately 3, 6, and 12 months. RESULTS Of 2497 patients enrolled in CHOICE, 1096 in the exenatide BID and 1239 in the insulin cohorts had ≥1 post-baseline assessment and were included in this analysis. Overall, 32.2% of the exenatide BID cohort and 29.1% of the insulin cohort (Kaplan-Meier estimates) had significant treatment change during the first 12 months, most commonly discontinuing injectable therapy or adding new T2DM therapy, respectively. Glycemic control improved in both cohorts, but weight loss occurred only in the exenatide BID cohort (mean change -3.3 kg). Hypoglycemia occurred in 13.2% of the exenatide BID cohort and 28.6% of the insulin cohort (82.8% and 55.6% of these patients, respectively, received sulfonylureas). The post hoc endpoint of glycated hemoglobin < 7%, no weight gain, and no hypoglycemia was attained at 12 months by 24.3% and 10.3% of patients who had data at 12 months and who were receiving exenatide BID and insulin, respectively. CONCLUSION About 30% of patients in CHOICE changed treatment in the first 12 months after initiation of first injectable therapy (exenatide BID or insulin). Overall, both cohorts achieved improved glycemic control, which was accompanied by a mean weight loss in the exenatide BID cohort.
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Rölver KM, Matthaei S, Lueg A, Lutze B, Lange K. Lebenschancen junger Erwachsener mit Typ 1 Diabetes. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Behandlung des Diabetes mellitus Typ 2*. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kellerer M, Matthaei S. Praxisempfehlungen der Deutschen Diabetes Gesellschaft. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Matthaei S, Reaney M, Mathieu C, Ostenson CG, Krarup T, Guerci B, Kiljanski J, Petto H, Bruhn D, Theodorakis M. Patients with Type 2 Diabetes Initiating Exenatide Twice Daily or Insulin in Clinical Practice: CHOICE Study. Diabetes Ther 2012; 3:6. [PMID: 22714818 PMCID: PMC3508107 DOI: 10.1007/s13300-012-0006-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Changes to Treatment and Outcomes in Patients with Type 2 Diabetes Initiating Injectable Therapy (CHOICE) is a European prospective, observational cohort study assessing time to, and factors associated with, a significant change in therapy after type 2 diabetes patients initiate their first injectable glucose-lowering therapy, and these patients' clinical outcomes over 24 months. The authors report baseline data and factors associated with the injectable treatment regimen. METHODS Demographic, clinical, and healthcare resource-use data were collected at initiation of injectable therapy and analyzed using univariate tests between cohorts and multivariate logistic regression analysis for treatment. RESULTS Overall, 1,177 patients initiated exenatide twice daily (b.i.d.) and 1,315 initiated insulin. Most patients were recruited by secondary-care physicians. Univariate analyses revealed statistically significant differences between the characteristics of patients who initiated exenatide b.i.d. and patients who initiated insulin. On multivariate analysis, higher body mass index [BMI; 5 kg/m(2) higher: odds ratio (OR) 2.10, 95% confidence intervals (CI) 1.84-2.40], lower glycated hemoglobin (HbA(1c); 1% higher: OR 0.77, 95% CI 0.69-0.86), and lower age (5 years older: OR 0.82, 95% CI 0.76-0.88) were the variables most strongly associated with increased probability of receiving exenatide b.i.d. (P < 0.0001). Patients initiating exenatide b.i.d. had a mean BMI of 35.3 ± 6.5 kg/m(2), HbA(1c) of 8.4 ± 1.4%, and age of 58 ± 10 years, compared with 29.7 ± 5.4 kg/m(2), 9.2 ± 1.9%, and 64 ± 11 years, respectively, in patients initiating insulin (P < 0.0001). Other characteristics significantly associated with exenatide b.i.d. initiation were "disinhibited eating" (Diabetes Health Profile-18), lower random blood glucose, less blood glucose self-monitoring, lower low-density lipoprotein cholesterol, and receipt of diet/exercise advice. CONCLUSIONS Patients who initiated exenatide b.i.d. were on average younger and more obese with lower HbA(1c) than those initiating insulin.
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Lemke C, Petruschke T, Wallace JF, Pardo S, Parkes JL, Matthaei S. Vergleichende Evaluierung des Blutzuckermesssystems CONTOUR XT®. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Reaney M, Matthaei S, Kiljanski J, Nicolay C. Therapie-assoziierte Faktoren bei Patienten mit Typ-2-Diabetes, die erstmalig mit einem injizierbaren Antidiabetikum behandelt werden sowie deren Behandlungsergebnisse nach 6 Monaten: Die CHOICE-Studie in Deutschland. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0031-1283989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Behandlung des Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kellerer M, Matthaei S. Praxisempfehlungen der Deutschen Diabetes-Gesellschaft. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Behandlung des Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Behandlung des Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1262619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lange M, Thienel F, Kläne-Menke I, Schadwinkel N, Wernsing M, Matthaei S. Therapie des Typ-2-Diabetes: Nachhaltige Reduktion kardiovaskulärer Risikoparameter 12 Monate nach strukturierter Diabetes-Schulung und Initiierung einer zielwertorientierten, multifaktoriellen Therapie. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1247335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thienel FT, Kläne-Menke I, Matthaei S. Diabetisches Fußsyndrom: Druckentlastung mittels VACOdiaped® im Vergleich mit Total Contact Cast (TCC) und Orthese. Ergebnisse einer Pilotstudie. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Del Prato S, LaSalle J, Matthaei S, Bailey CJ. Tailoring treatment to the individual in type 2 diabetes practical guidance from the Global Partnership for Effective Diabetes Management. Int J Clin Pract 2010; 64:295-304. [PMID: 20456169 PMCID: PMC2814090 DOI: 10.1111/j.1742-1241.2009.02227.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Good glycaemic control continues to be the most effective therapeutic manoeuvre to reduce the risk of development and/or progression of microvascular disease, and therefore remains the cornerstone of diabetes management despite recent scepticism about tight glucose control strategies. The impact on macrovascular complications is still a matter of debate, and so glycaemic control strategies should be placed in the context of multifactorial intervention to address all cardiovascular risk factors. Approaches to achieve glycaemic targets should always ensure patient safety, and results from recent landmark outcome studies support the need for appropriate individualisation of glycaemic targets and of the means to achieve these targets, with the ultimate aim to optimise outcomes and minimise adverse events, such as hypoglycaemia and marked weight gain. The primary goal of the Global Partnership for Effective Diabetes Management is the provision of practical guidance to improve patient outcomes and, in this article, we aim to support healthcare professionals in appropriately tailoring type 2 diabetes treatment to the individual. Patient groups requiring special consideration are identified, including newly diagnosed individuals with type 2 diabetes but no complications, individuals with a history of inadequate glycaemic control, those with a history of cardiovascular disease, children and individuals at risk of hypoglycaemia. Practical guidance specific to each group is provided.
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Matthaei S. [Type 2 diabetes: interview with Prof. Stephan Matthaei. Reaching HbA1c target value while preventing hypoglycemia]. MMW Fortschr Med 2009; 151:54. [PMID: 19938786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Behandlung des Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1224577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Matthaei S, Bierwirth R, Fritsche A, Gallwitz B, Häring HU, Joost HG, Kellerer M, Kloos C, Kunt T, Nauck M, Schernthaner G, Siegel E, Thienel F. Medical antihyperglycaemic treatment of type 2 diabetes mellitus: update of the evidence-based guideline of the German Diabetes Association. Exp Clin Endocrinol Diabetes 2009; 117:522-57. [PMID: 19876795 DOI: 10.1055/s-0029-1239559] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kausch C, Hamann A, Niendorf A, Joost HG, Dreyer M, Rüdiger HW, Holman GD, Greten H, Matthaei S. O-50: A novel mechanism of cellular insulin resistance: Defective insulin-stimulated glucose transport due to malinsertion of glucose transporters into the plasma membrane of fibroblasts from a patient with an insulin resistance syndrome. Exp Clin Endocrinol Diabetes 2009. [DOI: 10.1055/s-0029-1211541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
The high prevalence of obesity and its well documented association with the cardiovascular risk factors diabetes mellitus, dyslipidemia and hypertension represents a major problem for the general health status of industrialized societies. Although numerous studies have shown that genetic factors have a major influence on the regulation of energy homeostasis and the susceptibility to obesity, the genes and predisposing mutations involved are insufficiently understood. Among several known rodent models of obesity due to single gene mutations, mice homozygous for the obese (ob) gene exhibit massive early-onset obesity, hyperphagia, non-insulin-dependent diabetes mellitus, defective thermoregulation and infertility. Recently the ob gene was identified by positional cloning and shown to be mutated in ob/ob mice. Leptin, the product of the ob gene, is a 167-amino acid secreted protein that is synthesized exclusively in adipose tissue. With the exception of ob/ob mice, circulating plasma leptin is elevated in obesity. Administration of recombinant leptin to ob/ob mice reduces fat mass, food intake, hyperglycemia and hyperinsulinemia. The various effects of the hormone are mediated by leptin receptors expressed at high levels in the hypothalamus, but also in several other non-neuronal tissues. A mutation in the leptin receptor gene is responsible for the obese phenotype of db/db mice. Plasma leptin in humans is positively correlated with body fat mass, suggesting that leptin resistance rather than leptin deficiency is a common feature of human obesity. This review briefly summarizes the current status of the rapidly growing evidence that leptin plays an important role in the regulation of body weight and fat deposition.
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Matthaei S, Gallwitz B, Joost H, Kloos C, Schernthaner G, Thienel F. Diabetes mellitus Typ 2 – Therapie mit oralen Antidiabetika. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0028-1098872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lemke C, Matthaei S. Präzision und Richtigkeit der neuesten Version des Point of Care (POC) Gerätes A1CNow+. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1222097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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