Patterns and trends in insulin intensification among patients with type 2 diabetes: A systematic review

Abstract Type 2 diabetes (T2DM) diagnoses are skyrocketing, making treatment of this disease an increasing focus of primary care visits. Guidelines recommend insulin intensification over time to achieve HbA1c targets. We conducted a systematic review regarding patterns and trends of insulin intensif...

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Bibliographic Details
Published in:Primary care diabetes 2014-07, Vol.8 (2), p.101-109
Main Authors: Polinski, Jennifer M, Connolly, John G, Curtis, Bradley H, Seeger, John D, Gaskins, Kimela, Perez, Magaly, Smith, Benjamin F, Shrank, William H
Format: Article
Language:English
Subjects:
Biomarkers - blood
Blood Glucose - drug effects
Blood Glucose - metabolism
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - drug therapy
Endocrinology & Metabolism
Glycated Hemoglobin A - metabolism
Guideline Adherence - trends
Humans
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - adverse effects
Insulin - administration & dosage
Insulin - adverse effects
Insulin intensification
Internal Medicine
Patterns and trends
Practice Guidelines as Topic
Practice Patterns, Physicians' - trends
Primary Health Care - trends
Treatment Outcome
Type 2 diabetes
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Summary:Abstract Type 2 diabetes (T2DM) diagnoses are skyrocketing, making treatment of this disease an increasing focus of primary care visits. Guidelines recommend insulin intensification over time to achieve HbA1c targets. We conducted a systematic review regarding patterns and trends of insulin intensification and barriers to intensification. Providers across primary and specialty care settings often did not intensify insulin regimens despite patients’ clinical status. Even among progressed patients, HbA1c values remained high. The paucity of available studies prevented a comprehensive understanding of patterns and trends in insulin intensification. Such information is needed to assess the quality of pharmacologic care for patients with T2DM.
ISSN:1751-9918
1878-0210
DOI:10.1016/j.pcd.2013.10.008