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Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study
PURPOSE: To describe the extent of delays in insulin initiation, analyze its impact on glycemic control, and explore factors influencing delayed insulin initiation among Chinese type 2 diabetes mellitus (T2DM) patients. METHODS: A real-world, retrospective cohort study with regional electronic healt...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457728/ https://www.ncbi.nlm.nih.gov/pubmed/32922056 http://dx.doi.org/10.2147/DMSO.S256381 |
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author | Chen, Pin Ma, Xiao Chen, Hong Wang, Ke Zhou, Li |
author_facet | Chen, Pin Ma, Xiao Chen, Hong Wang, Ke Zhou, Li |
author_sort | Chen, Pin |
collection | PubMed |
description | PURPOSE: To describe the extent of delays in insulin initiation, analyze its impact on glycemic control, and explore factors influencing delayed insulin initiation among Chinese type 2 diabetes mellitus (T2DM) patients. METHODS: A real-world, retrospective cohort study with regional electronic health records from Fuzhou, southeast China was conducted among T2DM patients. Adult patients uncontrolled with oral antidiabetic drugs (OADs; HbA(1c) ≥7%) and initiated on insulin treatment were included. Time to insulin initiation was described. After propensity-score matching, Wilcoxon rank-sum test and chi-square test were used to compare follow-up HbA(1c) (first HbA(1c) 3 months after insulin initiation) between timely (initiated insulin within 6 months after OAD failure) and delayed (initiated after 6 months) insulin-initiation groups. Sensitivity analysis was also performed by linear and logistic regression. Factors associated with delayed insulin initiation were explored using logistic regression. RESULTS: A total of 940 patients were included, with mean±SD age 66.3±11.9 years. In sum, 328 had HbA(1c) recorded 3 months after insulin initiation. After propensity-score matching (1:1 matching), 184 patients were included for further analysis. Median follow-up HbA(1c) was lower in the timely-initiation group than the delayed-initiation group (7.25% vs 8.25%, P=0.009). Patients in the timely initiation group also had higher odds of achieving HbA(1c) <7% (OR=3.15, P=0.001). Results were confirmed by logistic regression. Hypertension, coronary artery disease, baseline HbA(1c), and hospital level at insulin initiation were associated with delays in insulin initiation. CONCLUSION: Timely insulin initiation after OAD failure is associated with better glycemic control. |
format | Online Article Text |
id | pubmed-7457728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-74577282020-09-11 Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study Chen, Pin Ma, Xiao Chen, Hong Wang, Ke Zhou, Li Diabetes Metab Syndr Obes Original Research PURPOSE: To describe the extent of delays in insulin initiation, analyze its impact on glycemic control, and explore factors influencing delayed insulin initiation among Chinese type 2 diabetes mellitus (T2DM) patients. METHODS: A real-world, retrospective cohort study with regional electronic health records from Fuzhou, southeast China was conducted among T2DM patients. Adult patients uncontrolled with oral antidiabetic drugs (OADs; HbA(1c) ≥7%) and initiated on insulin treatment were included. Time to insulin initiation was described. After propensity-score matching, Wilcoxon rank-sum test and chi-square test were used to compare follow-up HbA(1c) (first HbA(1c) 3 months after insulin initiation) between timely (initiated insulin within 6 months after OAD failure) and delayed (initiated after 6 months) insulin-initiation groups. Sensitivity analysis was also performed by linear and logistic regression. Factors associated with delayed insulin initiation were explored using logistic regression. RESULTS: A total of 940 patients were included, with mean±SD age 66.3±11.9 years. In sum, 328 had HbA(1c) recorded 3 months after insulin initiation. After propensity-score matching (1:1 matching), 184 patients were included for further analysis. Median follow-up HbA(1c) was lower in the timely-initiation group than the delayed-initiation group (7.25% vs 8.25%, P=0.009). Patients in the timely initiation group also had higher odds of achieving HbA(1c) <7% (OR=3.15, P=0.001). Results were confirmed by logistic regression. Hypertension, coronary artery disease, baseline HbA(1c), and hospital level at insulin initiation were associated with delays in insulin initiation. CONCLUSION: Timely insulin initiation after OAD failure is associated with better glycemic control. Dove 2020-08-25 /pmc/articles/PMC7457728/ /pubmed/32922056 http://dx.doi.org/10.2147/DMSO.S256381 Text en © 2020 Chen et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Chen, Pin Ma, Xiao Chen, Hong Wang, Ke Zhou, Li Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title | Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title_full | Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title_fullStr | Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title_full_unstemmed | Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title_short | Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study |
title_sort | delays in insulin initiation among patients with type 2 diabetes mellitus in southeast china: a retrospective, real-world study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457728/ https://www.ncbi.nlm.nih.gov/pubmed/32922056 http://dx.doi.org/10.2147/DMSO.S256381 |
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