PMID- 37604284
OWN - NLM
STAT- MEDLINE
DCOM- 20231010
LR  - 20231010
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 203
DP  - 2023 Sep
TI  - Factors associated with therapeutic inertia in individuals with type 2 diabetes 
      mellitus started on basal insulin.
PG  - 110888
LID - S0168-8227(23)00651-4 [pii]
LID - 10.1016/j.diabres.2023.110888 [doi]
AB  - AIM: In this study we aim to identify the factors associated with treatment 
      inertia in patients with type 2 diabetes mellitus (T2DM) who have been recently 
      started on basal insulin (BI). METHODS: Using UK CPRD GOLD, we identified adults 
      with T2DM with suboptimal glycaemia (HbA1c within 12 months of BI >/= 7% 
      (>/=53 mmol/mol)). We used multivariable Cox regression model to describe the 
      association between patient characteristics and the time to treatment 
      intensification. RESULTS: A total of 12,556 patients were analysed. Compared to 
      individuals aged < 65 years, those aged >/= 65 years had lower risk of treatment 
      intensification (HR: 0.69; 95% CI: 0.64-0.73). Other factors included being 
      female (0.93, 0.89-0.99), longer T2DM duration (0.99, 0.98-0.99), living in the 
      most deprived areas (0.90, 0.83-0.98), being a current smoker (0.91, 0.84-0.98), 
      having one (0.91, 0.85-0.97) or more than one comorbidity (0.88, 0.82-0.94), and 
      patients who were on metformin (0.71, 0.63-0.80), or 2nd generation 
      sulphonylureas (0.85; 0.79-0.92) or DPP4 inhibitors (0.87, 0.82-0.93) compared to 
      those who were not. CONCLUSION: Therapeutic inertia still remains a major 
      barrier, with multiple factors associated with delay in intensification. 
      Interventions to overcome therapeutic inertia need to be implemented at both 
      patient and health care professional level.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Shabnam, Sharmin
AU  - Shabnam S
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Gillies, Clare L
AU  - Gillies CL
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Davies, Melanie J
AU  - Davies MJ
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Dex, Terry
AU  - Dex T
AD  - Department of Medical Affairs, Sanofi, Bridgewater, NJ, USA.
FAU - Melson, Eka
AU  - Melson E
AD  - Leicester Diabetes Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Khunti, Kamlesh
AU  - Khunti K
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Webb, David R
AU  - Webb DR
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Zaccardi, Francesco
AU  - Zaccardi F
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK.
FAU - Seidu, Samuel
AU  - Seidu S
AD  - Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General 
      Hospital, University of Leicester, Leicester LE5 4PW, UK; Leicester Diabetes 
      Centre, Leicester General Hospital, Leicester LE5 4PW, UK. Electronic address: 
      sis11@leicester.ac.uk.
LA  - eng
PT  - Journal Article
DEP - 20230819
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 9100L32L2N (Metformin)
RN  - 0 (Sulfonylurea Compounds)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Female
MH  - Male
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Hypoglycemic Agents/therapeutic use/pharmacology
MH  - Insulin/therapeutic use
MH  - *Metformin/therapeutic use
MH  - Sulfonylurea Compounds/therapeutic use
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Basal insulin
OT  - Suboptimal glycaemic level
OT  - Therapeutic inertia
OT  - Type 2 diabetes mellitus
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/08/22 00:41
MHDA- 2023/10/10 06:41
CRDT- 2023/08/21 19:25
PHST- 2023/06/13 00:00 [received]
PHST- 2023/08/10 00:00 [revised]
PHST- 2023/08/18 00:00 [accepted]
PHST- 2023/10/10 06:41 [medline]
PHST- 2023/08/22 00:41 [pubmed]
PHST- 2023/08/21 19:25 [entrez]
AID - S0168-8227(23)00651-4 [pii]
AID - 10.1016/j.diabres.2023.110888 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2023 Sep;203:110888. doi: 10.1016/j.diabres.2023.110888. 
      Epub 2023 Aug 19.