کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2676295 1141848 2012 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Initiation of insulin among veterans with type 2 diabetes and sustained elevation of A1c
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Initiation of insulin among veterans with type 2 diabetes and sustained elevation of A1c
چکیده انگلیسی

AimTo examine if the relationship between insulin initiation and glycemic control among veterans with poorly controlled type 2 diabetes (T2DM) varies by the number of oral-glucose-lowering-medication classes used prior to insulin initiation.MethodsThe cohort consisted of veterans with T2DM with at least two glycosolated hemoglobins (A1c) ≥8.0% within a 12-month period but without prior insulin use. The study period was October 1998 until May 2006. Cox regression analyses were used to assess the predictors of the rate of insulin initiation.ResultsAmong 40,537 who met the inclusion criteria, 17,519 (43.2%) had insulin initiated over a median follow-up period of 58.6 months. The rate of insulin initiation due to 1% increase in A1c increased by 33.6%, 28.8%, 24.2%, 19.7%, 15.4% for patients exposed to 0, 1, 2, 3, 4 classes of oral-glucose-lowering agents. A higher insulin initiation rate was also associated with younger age, more comorbidities, non-Hispanic white race/ethnicity, obesity, longer diabetes duration, and attending endocrinology clinics.ConclusionsPoor glycemic control is associated with increased rates of insulin initiation. This relationship is attenuated by the number of distinct oral-glucose-lowering-medication classes used prior to insulin initiation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Primary Care Diabetes - Volume 6, Issue 1, April 2012, Pages 19–25
نویسندگان
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