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Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations
OBJECTIVE: To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. RESEARCH DESIGN AND METHODS: Study of Once‐Daily Levemir (SOLVE (™)) is an international, 24‐week, observational study of insulin initiation in people...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832583/ https://www.ncbi.nlm.nih.gov/pubmed/26916450 http://dx.doi.org/10.1111/ijcp.12776 |
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author | Orozco‐Beltran, D. Pan, C. Svendsen, A. L. Færch, L. Caputo, S. |
author_facet | Orozco‐Beltran, D. Pan, C. Svendsen, A. L. Færch, L. Caputo, S. |
author_sort | Orozco‐Beltran, D. |
collection | PubMed |
description | OBJECTIVE: To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. RESEARCH DESIGN AND METHODS: Study of Once‐Daily Levemir (SOLVE (™)) is an international, 24‐week, observational study of insulin initiation in people with type 2 diabetes. RESULTS: A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) −1.2 ± 1.4% (−13.1 ± 15.3 mmol/mol) and −1.3 ± 1.6% (−14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [−0.04%, 95% confidence interval (CI) −0.09 to −0.01 (−0.4 mmol/mol, 95% CI −1.0−0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06–0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64–0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). CONCLUSIONS: Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation. |
format | Online Article Text |
id | pubmed-4832583 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-48325832016-04-27 Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations Orozco‐Beltran, D. Pan, C. Svendsen, A. L. Færch, L. Caputo, S. Int J Clin Pract Endocrinology and Metabolism OBJECTIVE: To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. RESEARCH DESIGN AND METHODS: Study of Once‐Daily Levemir (SOLVE (™)) is an international, 24‐week, observational study of insulin initiation in people with type 2 diabetes. RESULTS: A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) −1.2 ± 1.4% (−13.1 ± 15.3 mmol/mol) and −1.3 ± 1.6% (−14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [−0.04%, 95% confidence interval (CI) −0.09 to −0.01 (−0.4 mmol/mol, 95% CI −1.0−0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06–0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64–0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). CONCLUSIONS: Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation. John Wiley and Sons Inc. 2016-02-24 2016-02-26 /pmc/articles/PMC4832583/ /pubmed/26916450 http://dx.doi.org/10.1111/ijcp.12776 Text en © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Endocrinology and Metabolism Orozco‐Beltran, D. Pan, C. Svendsen, A. L. Færch, L. Caputo, S. Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title | Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title_full | Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title_fullStr | Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title_full_unstemmed | Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title_short | Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
title_sort | basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations |
topic | Endocrinology and Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832583/ https://www.ncbi.nlm.nih.gov/pubmed/26916450 http://dx.doi.org/10.1111/ijcp.12776 |
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