Primary care physicians and insulin initiation: multiple barriers, lack of knowledge or both?: Editorials
Open accessAbstract
Primary care physicians (PCPs) provide diabetes care for 82% of patients with type 2 diabetes (1). Many patients with type 2 diabetes will eventually need insulin. The UKPDS (2) showed that ß-cell failure is progressive. From 50% of normal ß-cell function present at diagnosis, there is a steady decline with almost complete loss of ß-cell mass within 10-15 years, even earlier in some patients. On average, as many as 40-80% of patients with type 2 diabetes will need insulin within 10 years after diagnosis (1,2). These statistics can vary between patients and depending on the different agents used after the initial diagnosis. UKPDS did not include thiazolidinediones or GLP-1 based therapies, which could potentially have a completely different effect on the ß-cells and perhaps delay the need for insulin.
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Progressive hyperglycemia results in increasing use of pharmacologic agents over time and the eventual need for insulin therapy in approximately half of all patients.
“This results in increasing use of pharmacologic agents over time and the eventual need for insulin therapy in approximately half of all patients (77).”
From Diabetes and Cancer (2010) · cites this paper as [77]
Between 40-80% of individuals with type 2 diabetes will ultimately be considered for insulin therapy to achieve glycemic targets.
“Between 40–80% of individuals with type 2 diabetes will ultimately be considered for insulin therapy in an effort to achieve glycemic targets (77).”
From Diabetes and Cancer (2010) · cites this paper as [77]
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DeWitt, D. E., & Hirsch, I. B. (2003) · JAMA · doi:10.1001/jama.289.17.2254 · Cited by 502 · see citing works
Clinical Inertia in Response to Inadequate Glycemic Control
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Self-citationThe underuse of insulin therapy in North America
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Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2012) · Diabetologia · doi:10.1007/s00125-012-2534-0 · Cited by 3,919 · see citing works
Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach
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Giovannucci, E., Harlan, D. M., Archer, M. C., Bergenstal, R. M., Gapstur, S. M., Habel, L. A., Pollak, M., Regensteiner, J. G., & Yee, D. (2010) · Diabetes Care · doi:10.2337/dc10-0666 · Cited by 2,366 · see citing works
- Authors
- Jabbour, S.
- Affiliations
- Thomas Jefferson University (US)
- Corresponding author
- Jabbour, S
- ORCID
- Jabbour, S
- Venue
- International Journal of Clinical Practice
- Publisher
- Hindawi Limited
- Published
- 2008-06-28
- Volume
- 62
- Issue
- 6
- Pages
- 845-847
- ISSN
- 1368-5031 (ISSN-L)
- OpenAlex
- W1771148581
- Cited by
- 44
- References
- 12
- Citations by year
- 2022: 1 · 2020: 4 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 6 · 2014: 10 · 2013: 7 · 2012: 9
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- The Medicine Forum (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- insulin initiation, type 2 diabetes, primary care physicians, barriers to insulin therapy, physician knowledge, beta-cell failure, UKPDS, thiazolidinediones, GLP-1 receptor agonists, diabetes management
- MeSH terms
- Clinical Competence, Diabetes Mellitus, Type 2, Family Practice, Humans, Hypoglycemic Agents, Insulin
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