Elsevier

Endocrine Practice

Volume 18, Issue 5, September–October 2012, Pages 660-667
Endocrine Practice

Original Article
The V-Go Insulin Delivery Device Used In Clinical Practice: Patient Perception and Retrospective Analysis of Glycemic Control

https://doi.org/10.4158/EP11362.ORGet rights and content

ABSTRACT

Objective

To describe patient perceptions regarding their experience and to report findings in a retrospective analysis of glycemic control in a cohort of patients who used the V-Go, a mechanical, 24-hour disposable, subcutaneous continuous insulin delivery device that delivers a preset basal infusion rate and on-demand insulin.

Methods

Patients used the V-Go and answered telephone surveys about their perception of device use. Corresponding clinical data were retrospectively collected before V-Go initiation, after 12 weeks of use, at the end of treatment, and 12 weeks after discontinuation. Analyses were performed with nonparametric statistical tests.

Results

Twenty-three patients participated. Mean values of the following characteristics were documented: patient age, 61 years; body mass index, 30 kg/m2; diabetes duration, 16 years; duration of insulin therapy, 7 years; average duration of V-Go use, 194 days; and mean total daily insulin dose, 50 U at baseline, 46 U while on V-Go, and 51 U after stopping V-Go treatment. Mean patient rating of the overall experience was 9.1 at 12 weeks on a scale from 1 to 10 (10 being most positive). Mean hemoglobin A1c value decreased from baseline (8.8% to 7.6%; [P = .005]) while using the V-Go, and it increased to 8.2% after treatment. Fasting plasma glucose trended from 205 mg/dL at baseline to 135 mg/dL while using V-Go and increased to 164 mg/dL after V-Go was stopped. Weight was essentially unchanged. No differences in hypoglycemic events were found; site reactions were minor.

Conclusion

Glycemic control improved when patients were switched to the V-Go for insulin delivery, and it deteriorated when the V-Go was discontinued. (Endocr Pract. 2012;18:660-667)

Section snippets

INTRODUCTION

Despite an average decrease in hemoglobin A1c (A1C) in the US population with diabetes, two-thirds of patients treated with insulin (with or without combination treatment with oral drugs) do not meet the less than 7.0% American Diabetes Association target (1). Progressing the insulin regimen from oral agents in combination with a single daily injection of an intermediate-acting or long-acting insulin to 2 or more injections a day results in better glycemic control (2). However, insulin therapy

METHODS

The V-Go used in the program was that which is marketed in the United States. It is available in 20, 30, or 40 U per 24 hours preset basal rate with an additional 36 U of insulin available for bolus administration in 2 U increments on demand. The fill adapter was a prototype quite different and less user-friendly than the version that the company has marketed in the United States.

Physicians who expressed interest in the V-Go were offered a supply of V-Go for patients they thought would benefit

RESULTS

Available Data, Demographic Information,  Medication Use, and Exposure

Two of 10 physicians from the prospective data collection did not participate in the retrospective data collection. Some patients were lost to follow-up and 1 patient developed dementia since the original data collection, which rendered the patient incapable of giving informed consent. Overall, 23 of the 31 originally treated patients (74%) were represented with clinical data.

Table 1 displays the demographic data for all

ACKNOWLEDGMENT

Valeritas supplied the V-Go and fill devices used and supported the data collection and statistical analysis with a grant.

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