José Escribano-Serrano, Unidad de Gestión Clínica de San Roque, Área de Gestión Sanitaria Campo de Gibraltar, San Roque (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
Enrique Jiménez-Varo, Unidad de Gestión Clínica Laboratorio, Hospital de la Línea, La Línea de la Concepción (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
María-Isabel Méndez-Esteban, Unidad de Gestión Clínica Farmacia, Área de Gestión Sanitaria Campo de Gibraltar, Algeciras (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
Antonio García-Bonilla, Unidad de Gestión Clínica Farmacia, Distrito Jerez-Costa, Área de Gestión Sanitaria Norte de Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
Manuela Márquez-Ferrando, Servicio de Farmacia, Distrito de Atención Primaria, Bahía de Cádiz-La Janda, Cádiz, Spain
Antonio Hormigo-Pozo, Unidad de Gestión Clínica San Andrés Torcal, Distrito de Atención Primaria Málaga Guadalhorce, Málaga, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
José Mancera-Romero, Unidad de Gestión Clinica Ciudad Jardín, Distrito de Atención Primaria Málaga Guadalhorce, Málaga, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain
Alfredo Michán-Doña, Departamento de Medicina Hospital Universitario de Jerez, Universidad de Cádiz, Jerez de la Frontera (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Cádiz, Spain

Aim: The aim of this study was to analyze the patterns of insulin consumption between 2014 and 2018 in Cádiz. Methods: This study was a cross-sectional retrospective study. All people that used any insulin were included in the study. The Cadiz Diabetes Database includes data on yearly anti-diabetic prescriptions and hemoglobin A1c (HbA1c) levels. Results: The prevalence of insulin-users was 2.15%. More prevalent in women and increased with age (0.18% in the 0-15-year-old group to 8.53% in the > 75-year-old group); insulin’ users represent 28.8% of the total population with diabetes mellitus treatments. Seventy percent of insulin-treated patients (ITP) were over 60 years old. Long-acting insulin was consumed by 79% of users, representing 55% of the total insulin types consumed. Glargine was the most consumed (4,654,000 defined daily dose and valuing > 7.000.000€ in 2018). In > 75-year-old group, 50% were treated with long-acting and fast-acting insulin combinations. Annual HbA1c was determined for two out of three ITP and 37% of these had Hb1Ac < 7% (53 mmol/mol). Conclusions: The Cadiz population presents a high consumption of insulin. Insulin prescription patterns have changed during the study. Long-acting insulins, especially Glargine (alone or in combination), are the most widely used types of insulin. In the group of elderly patients, the patterns found are not in line with the current recommendations. ITP in Cadiz has a poor glycemic (median HbA1c 7.84%) control and a low amount of Hb1Ac determinations.

Keywords: Diabetes mellitus. Insulin-treated patients. Prevalence insulin consumption. Insulin patterns. Glycemic control.