PMID- 32922056
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220416
IS  - 1178-7007 (Print)
IS  - 1178-7007 (Electronic)
IS  - 1178-7007 (Linking)
VI  - 13
DP  - 2020
TI  - Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in 
      Southeast China: A Retrospective, Real-World Study.
PG  - 3059-3068
LID - 10.2147/DMSO.S256381 [doi]
AB  - 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.
CI  - (c) 2020 Chen et al.
FAU - Chen, Pin
AU  - Chen P
AD  - Department of Endocrinology, 900 Hospital of the Joint Logistics Team, Fuzhou 
      Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic 
      of China.
FAU - Ma, Xiao
AU  - Ma X
AD  - Lilly Suzhou Pharmaceutical, Shanghai, People's Republic of China.
FAU - Chen, Hong
AU  - Chen H
AD  - Lilly Suzhou Pharmaceutical, Shanghai, People's Republic of China.
FAU - Wang, Ke
AU  - Wang K
AD  - Lilly Suzhou Pharmaceutical, Shanghai, People's Republic of China.
FAU - Zhou, Li
AU  - Zhou L
AUID- ORCID: 0000-0003-3750-3309
AD  - Lilly Suzhou Pharmaceutical, Shanghai, People's Republic of China.
LA  - eng
PT  - Journal Article
DEP - 20200825
PL  - New Zealand
TA  - Diabetes Metab Syndr Obes
JT  - Diabetes, metabolic syndrome and obesity : targets and therapy
JID - 101515585
PMC - PMC7457728
OTO - NOTNLM
OT  - HbA1c
OT  - delayed insulin initiation
OT  - glycemic control
OT  - therapeutic inertia
OT  - type 2 diabetes mellitus
COIS- Li Zhou, Xiao Ma, and Hong Chen are employees of Lilly. Ke Wang was an employee 
      of Lilly at the time of manuscript preparation. Pin Chen has nothing to disclose. 
      Li Zhou reports personal fees from Eli Lilly and Company during the conduct of 
      the study. The authors report no other potential conflicts of interest for this 
      work.
EDAT- 2020/09/15 06:00
MHDA- 2020/09/15 06:01
PMCR- 2020/08/25
CRDT- 2020/09/14 05:49
PHST- 2020/04/01 00:00 [received]
PHST- 2020/07/10 00:00 [accepted]
PHST- 2020/09/14 05:49 [entrez]
PHST- 2020/09/15 06:00 [pubmed]
PHST- 2020/09/15 06:01 [medline]
PHST- 2020/08/25 00:00 [pmc-release]
AID - 256381 [pii]
AID - 10.2147/DMSO.S256381 [doi]
PST - epublish
SO  - Diabetes Metab Syndr Obes. 2020 Aug 25;13:3059-3068. doi: 10.2147/DMSO.S256381. 
      eCollection 2020.