An Observational Study to Understand Challenges Associated With Progression of Insulin Therapy in Type 2 Diabetes

Multivariable logistic regression model examined baseline participant-, physician-, and healthcare system-related factors associated with the occurrence of any change in insulin therapy. Discrimination domain of the Interpersonal Processes of Care Survey [IPC] ranges from 1-5 with higher scores indicating more discrimination and Diabetes Distress Scale ranges from 1-6 with higher scores indicating more distress.

Hypoglycemia and severe hypoglycemia episodes are self-reported by all participants with complete treatment data from one month prior to the baseline visit until the last visit (24 months). Patients were asked at each visit to self-report any hypoglycemia since their last visit. At the baseline visit participants were asked their hypoglycemia information for the month prior to the baseline visit.

MOSAIC participants answered the question: "How often did you miss your insulin shots during the last 7 days?". At each visit, participants were defined as visit adherent if the participant answered "I did not miss any shots" or "I missed some of my shots". They were defined as not visit adherent if he/she answered any of the following: "I missed about half of my shots", "I missed most of my shots", or "I missed all of my shots". A participant is defined to be study adherent if at least: 4 out of 5 visit adherent.

As diabetes management practices vary across the countries represented in MOSAIC, a more apt measure of reaching goal is the personalized target that was set for each patient at the beginning of the study.