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Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions
Joint Authors
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
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-09-19
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract 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.
American Psychological Association (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
Modern Language Association (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
American Medical Association (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
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1183827