Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions

المؤلفون المشاركون

Pontremoli, Roberto
Ceriello, Antonio
Giorda, Carlo
Guida, Pietro
Study Group, AMD-Annals
Gentile, Sandro
Piscitelli, Pamela
Fioretto, Paola
De Cosmo, Salvatore
Viazzi, Francesca
Russo, Giuseppina T.
Strollo, Felice

المصدر

Journal of Diabetes Research

العدد

المجلد 2018، العدد 2018 (31 ديسمبر/كانون الأول 2018)، ص ص. 1-10، 10ص.

الناشر

Hindawi Publishing Corporation

تاريخ النشر

2018-09-19

دولة النشر

مصر

عدد الصفحات

10

التخصصات الرئيسية

الأمراض
الطب البشري

الملخص EN

We performed a real-life analysis of clinical and laboratory parameters, in orally treated T2DM patients aiming at identifying predictors of insulin treatment initiation.

Overall, 366955 patients (55.8% males, age 65 ± 11 years, diabetes duration 7 ± 8 years) were followed up between 2004 and 2011.

Each patient was analyzed step-by-step until either eventually starting insulin treatment or getting to the end of the follow-up period.

Patients switching to insulin showed a worse global risk profile, longer disease duration (10 ± 9 years vs.

6 ± 7 years, respectively; p<0.001), higher HbA1c (8.0 ± 1.6% vs.

7.2 ± 1.5%, respectively; p<0.001), higher triglycerides, a greater prevalence of arterial hypertension, antihypertensive, lipid-lowering and aspirin treatment, a higher rate of nonproliferative/proliferative retinopathy, and a nearly 4 times lower prevalence of the “diet alone.” They also showed a higher prevalence of subjects with eGFR < 60 ml/min/1.73 m2 (24.0% vs.

16.2%, respectively; p<0.001).

Multivariate analysis identified diabetes duration, HbA1c, triglyceride and low HDL-C values, presence of retinopathy or renal dysfunction, and sulphonylurea utilization (the risk being approximately 3 times greater in the latter case) as independent predictors of insulin treatment initiation.

LDL-C, lipid-lowering treatment, and overweight/obese seem to be protective.

Results of tree analysis showed that patients on sulphonylurea, with high HbA1c, eGFR below 50 ml/min/1.73 m2, and at least 5-year disease duration, are at very high risk to start insulin treatment.

We have to stick to this real-life picture, of course, until enough data are collected on patients treated with innovative medications which are expected to improve beta cell survival and further delay treatment-related insulin requirement.

نمط استشهاد جمعية علماء النفس الأمريكية (APA)

Gentile, Sandro& Strollo, Felice& Viazzi, Francesca& Russo, Giuseppina T.& Piscitelli, Pamela& Ceriello, Antonio…[et al.]. 2018. Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions. Journal of Diabetes Research،Vol. 2018, no. 2018, pp.1-10.
https://search.emarefa.net/detail/BIM-1183827

نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)

Gentile, Sandro…[et al.]. Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions. Journal of Diabetes Research No. 2018 (2018), pp.1-10.
https://search.emarefa.net/detail/BIM-1183827

نمط استشهاد الجمعية الطبية الأمريكية (AMA)

Gentile, Sandro& Strollo, Felice& Viazzi, Francesca& Russo, Giuseppina T.& Piscitelli, Pamela& Ceriello, Antonio…[et al.]. Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions. Journal of Diabetes Research. 2018. Vol. 2018, no. 2018, pp.1-10.
https://search.emarefa.net/detail/BIM-1183827

نوع البيانات

مقالات

لغة النص

الإنجليزية

الملاحظات

Includes bibliographical references

رقم السجل

BIM-1183827