Abstract

Objective: To compare quality of life and treatment satisfaction when using insulin glargine + insulin lispro with that on NPH insulin + unmodified human insulin in adults with Type 1 diabetes managed with multiple injection regimens.

Research Design and Methods: As part of a 32-week, five-centre, two-way cross-over study in 56 people with Type 1 diabetes randomized to evening insulin glargine + meal-time insulin lispro or to NPH insulin (once- or twice-daily) + meal-time unmodified human insulin, the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Audit of Diabetes Dependent Quality of Life (ADDQoL) questionnaire were completed at baseline, weeks 16 and 32, with additional interim DTSQ measurements.

Results: For all patients combined, mean baseline present quality of life (QoL) score was 1.3, reflecting ‘good’ QoL. Present QoL improved with glargine+lispro but did not change with NPH+human insulin (1.6±0.1 [±SE] vs 1.3±0.1, difference 0.3 (95 % CI 0.1, 0.6), p=0.014). Baseline mean average weighted impact score (AWI) of diabetes on QoL was –1.8, indicating a negative impact of diabetes on QoL. AWI score at endpoint improved significantly with glargine+lispro but changed little with NPH+human insulin (−1.4±0.1 vs −1.7±0.1, 0.3 (0.0, 0.6), p=0.033). Treatment satisfaction (DTSQ 36-0 scale score) at endpoint was markedly greater with glargine+lispro compared with NPH+human insulin (32.2±3.4 vs 23.9±7.2, 8.6 (6.5, 10.6), p<0.001).

Conclusions: Insulin glargine + insulin lispro improves treatment satisfaction, reduces the negative impact of diabetes on QoL and improves QoL, in comparison with NPH insulin + unmodified human insulin in Type 1 diabetes.