Skip to main content

09-14-2018 | Psychosocial care | Article

Improved Treatment Engagement Among Patients with Diabetes Treated with Insulin Glargine 300 U/mL Who Participated in the COACH Support Program

Journal: Diabetes Therapy

Authors: Jennifer D. Goldman, Jasvinder Gill, Tony Horn, Timothy Reid, Jodi Strong, William H. Polonsky

Publisher: Springer Healthcare




Persistence with basal insulin therapy can be suboptimal, despite recent improvements in insulin formulations and delivery systems. Patient support programs may help increase adherence. This study evaluated the impact of the Toujeo® COACH support program, which provides patients with continuing and individualized education and advice on lifestyle changes, by assessing its effect on number of refills and days on therapy.


The study population included 1724 patients with diabetes who filled a first prescription for insulin glargine 300 U/mL (Gla-300) between April and December 2015 and received a welcome call from a Guide, and 1724 matched control patients from the Symphony Health Integrated Dataverse® prescription claims database. Control patients received Gla-300 but did not enroll in the program. These patients were matched based on age, gender, location, prior use of insulin, insulin dose, number of concomitant drugs, and copay tier.


The COACH and control groups comprised 52% men and 48% women; 22% were aged 18–47 years, 23% were 48–55 years, 27% 56–61 years, and 28% ≥ 62 years. Most (99%) had used insulin in the year before receiving the welcome call. At 6 months, patients in the COACH group had refilled their prescription 3.2 times on average, compared with 2.4 times for control patients (P < 0.0001); at 9 months, the average number of refills was 4.7 and 3.6, respectively (P < 0.0001). The average number of days on therapy at 6 months was 102.2 days in the COACH group and 81.5 days in the control group (P < 0.0001); at 9 months, the average number of days on therapy was 151.9 and 121.6, respectively (P < 0.0001).


Patients in the COACH program were significantly more likely to refill their prescriptions and stay on therapy. Patient support programs such as the COACH program could be an effective way to help improve diabetes care.


Sanofi US, Inc. and McKesson Corporation.
American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Suppl 1):S1–159.
Kesavadev J, Joshi S, Saboo B, et al. Improved short term and long term outcomes of early insulin initiation in type 2 diabetes over 10 years. Endocr Pract. 2017;23(Suppl 3):50.
Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140–9. CrossRef
Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2018 executive summary. Endocr Pract. 2018;24:91–120. CrossRef
Polonsky WH, Arsenault J, Fisher L, et al. Initiating insulin: how to help people with type 2 diabetes start and continue insulin successfully. Int J Clin Pract. 2017;71:e12973. https://​doi.​org/​10.​1111/​ijcp.​12973. CrossRef
Peyrot M, Perez-Nieves M, Ivanova J, et al. Correlates of basal insulin persistence among insulin-naïve people with type 2 diabetes: results from a multinational survey. Curr Med Res Opin. 2017;33:1843–51. CrossRef
Sanofi US, Inc. Toujeo (package insert). Bridgewater: Sanofi US, Inc.; 2015.
Riddle MC, Yki-Järvinen H, Bolli GB, et al. One-year sustained glycaemic control and less hypoglycaemia with new insulin glargine 300 U/ml compared with 100 U/ml in people with type 2 diabetes using basal plus meal-time insulin: the EDITION 1 12-month randomized trial, including 6-month extension. Diabetes Obes Metab. 2015;17:835–42. CrossRef
Yki-Järvinen H, Bergenstal RM, Ziemen M, et al. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using oral agents and basal insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diabetes Care. 2014;37:3235–43. CrossRef
Freemantle N, Chou E, Frois C, et al. Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis. BMJ Open. 2016;6:e009421. CrossRef
Wei W, Jiang J, Lou Y, Ganguli S, Matusik MS. Benchmarking insulin treatment persistence among patients with type 2 diabetes across different U.S. payer segments. J Manag Care Spec Pharm. 2017;23:278–90. PubMed
Perez-Nieves M, Kabul S, Desai U, et al. Basal insulin persistence, associated factors, and outcomes after treatment initiation among people with type 2 diabetes mellitus in the US. Curr Med Res Opin. 2016;32:669–80. CrossRef
Miller ED. Basal insulin in primary care. J Fam Pract. 2016;65(Suppl 10):S3–7.
Ganguli A, Clewell J, Shillington AC. The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review. Patient Prefer Adherence. 2016;10:711–25. PubMedPubMedCentral
Sanofi US, Inc. Toujeo COACH support program. https://​www.​toujeo.​com/​toujeo-savings-and-support. Accessed 24 May 2018.
Symphony Health, LLC. Integrated Dataverse. http://​symphonyhealth.​com/​product/​idv/​. Accessed 24 May 2018.
Kim KB, Kim MT, Lee HB, Nguyen T, Bone LR, Levine D. Community health workers versus nurses as counselors or case managers in a self-help diabetes management program. Am J Public Health. 2016;106:1052–8. CrossRef
Watts SA, Sood A. Diabetes nurse case management: improving glucose control: 10 years of quality improvement follow-up data. Appl Nurs Res. 2016;29:202–5. CrossRef
Philis-Tsimikas A, Gallo LC. Implementing community-based diabetes programs: the Scripps Whittier Diabetes Institute experience. Curr Diab Rep. 2014;14:462.
Gary TL, Batts-Turner M, Yen HC, et al. The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus. Ann Intern Med. 2009;169:1788–94. CrossRef
Piette JD, Weinberger M, Kraemer FB, McPhee SJ. Impact of automated calls with nurse follow-up on diabetes treatment outcomes in a Department of Veterans Affairs Health Care System: a randomized controlled trial. Diabetes Care. 2001;24:202–8. CrossRef
Sacco WP, Morrison AD, Malone JI. A brief, regular, proactive telephone “coaching” intervention for diabetes: rationale, description, and preliminary results. J Diabetes Complicat. 2004;18:113–8. CrossRef
MacLean LG, White JR, Broughton S, et al. Telephone coaching to improve diabetes self-management for rural residents. Clin Diabetes. 2012;30:13–6. CrossRef
Wang Y, Xue H, Huang Y, Huang L, Zhang D. A systematic review of application and effectiveness of mHealth interventions for obesity and diabetes treatment and self-management. Adv Nutr. 2017;8:449–62. CrossRef
Pillay J, Armstrong MJ, Butalia S, et al. Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis. Ann Intern Med. 2015;163:848–60. CrossRef
Daubresse M, Andersen M, Riggs KR, Alexander GC. Effect of prescription drug coupons on statin utilization and expenditures: a retrospective cohort study. Pharmacotherapy. 2017;37:12–24. CrossRef

New additions to the Adis Journal Club

A selection of topical peer-reviewed articles from the Adis journals, curated by the editors.

ADA 2022 coverage

Access the latest news and expert insight from the ADA 82nd Scientific Sessions