OBJECTIVES: Pharmacokinetic profiles suggest that weekly insulin medications currently under investigation may differ in glycemic variability (GV), which refers to oscillations in blood glucose levels within and between days. Therefore, the purpose of this study was to examine preferences and estimate utility differences associated with GV among people with type 1 (T1D) and type 2 diabetes (T2D).

METHODS: Preferences for two health state vignettes were rated by participants with T1D and T2D in the UK on a 7-point rating scale and in time trade-off (TTO) interviews. Vignettes described treatment with weekly basal insulin in combination mealtime insulin (T1D) or oral medications (T2D) and blood glucose levels that are generally in control. The low GV health state described blood glucose levels that are “mostly steady within the target range.” The high GV health state described morning blood glucose that varies from day-to-day within target range and blood glucose that varies throughout the day within the target range.

RESULTS: The sample included 86 participants with T1D (55.8% female; mean age = 36.6 years) and 203 participants with T2D (48.3% female; mean age = 55.1 years). Nearly all participants with T1D (97.6%) preferred low GV, and most (67.4%) rated this preference as strong. Low GV was also preferred by nearly all participants with T2D (99.5%), and most (73.4%) rated this preference as strong. Weekly basal insulin with low GV was associated with a higher utility than weekly basal insulin with high GV among patients with T1D (utility difference = 0.024; p<0.0001) and T2D (utility difference = 0.025; p<0.0001).

CONCLUSIONS: Findings suggest that differences in GV are important to patients with T1D and T2D, even when blood glucose remains within the target range. The health state utilities estimated in this study may be useful in cost-effectiveness models evaluating weekly insulins with differences in GV.