ArticleCanadian family physician Medecin de famille canadien2010
Clinical inertia in patients with T2DM requiring insulin in family practice.
Article in Canadian family physician Medecin de famille canadien, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Glycaemic control and hypoglycaemia burden in patients with type 2 diabetes initiating basal insulin in Europe and the USA.Diabetes, obesity & metabolism · 2017Pooled it
- Translating What Works: A New Approach to Improve Diabetes Management.Journal of diabetes science and technology · 2015Trial
- Insulin lispro low mixture twice daily versus basal insulin glargine once daily and prandial insulin lispro once daily in patients with type 2 diabetes requiring insulin intensification: a randomized phase IV trial.Diabetes, obesity & metabolism · 2014Trial
- Impact of baseline insulin regimen on glycemic response to a group medical clinic intervention.Diabetes care · 2013Trial
- Can community retail pharmacist and diabetes expert support facilitate insulin initiation by family physicians? Results of the AIM@GP randomized controlled trial.BMC health services research · 2013Trial
- Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge.Diabetes research and clinical practice · 2012Trial
- An observational study of clinical inertia among patients with type 2 diabetes mellitus in a tertiary care hospital.Archives of medical science : AMS · 2026Article
- What Primary Care Clinicians Need to Know About Once-Weekly Insulins.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Article
- Evaluating Patient and Provider Preferences for a Once-Weekly Basal Insulin in Adults with Type 2 Diabetes.Patient preference and adherence · 2024Article
- Barriers and Facilitators to the Initiation of Injectable Therapies for Type 2 Diabetes Mellitus: A Mixed Methods Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022Article
- A Safe and Simple Algorithm for Adding and Adjusting Mealtime Insulin to Basal-Only Therapy.Clinical diabetes : a publication of the American Diabetes Association · 2022Article
- Tolerability and Effectiveness of Switching to Dulaglutide in Patients With Type 2 Diabetes Inadequately Controlled With Insulin Therapy.Frontiers in endocrinology · 2022Article
- Effect of Diabetes-Trained Nurse Practitioners on Glycemic Outcomes: Their Suggested Use in Busy Primary Care Practices.Clinical diabetes : a publication of the American Diabetes Association · 2021Article
- A Real-World, Observational Study of the Initiation, Use, and Effectiveness of Basal-Bolus or Premixed Insulin in Japanese People with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Review
- Therapeutic Inertia in People With Type 2 Diabetes in Primary Care: A Challenge That Just Won't Go Away.Diabetes spectrum : a publication of the American Diabetes Association · 2020Article
- Timing of GLP-1 Receptor Agonist Initiation for Treatment of Type 2 Diabetes in the UK.Drugs in R&D · 2019Article
- Effect of Remote Glucose Monitoring Utilizing Computerized Insulin Dose Adjustment Algorithms: A Pilot Project.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2019Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the clinical status of patients with type 2 diabetes mellitus (T2DM) in the primary care setting at insulin initiation and during follow-up, and to assess the efficacy of insulin initiation and intensification.
designOntario FPs from the IMS Health database who had prescribed insulin at least once in the 12 months before November 2006 were randomly selected to receive an invitation to participate. Eligible and consenting FPs completed a questionnaire for each of up to 10 consecutive eligible patients. Patient data were recorded from 3 time points.
settingFamily practices in Ontario, Canada.
participantsOne hundred and nine FPs and 379 of their T2DM patients taking insulin (with or without oral agents).
main outcome measuresGlycated hemoglobin (HbA₁(c)) levels, daily insulin dose, and use of concomitant oral agents at insulin initiation and 2 subsequent visits.
resultsData from each patient were obtained on insulin initiation and intensification, glycemic control, further pharmacologic therapy, and related complications. Mean time from diagnosis of T2DM to insulin initiation was 9.2 years. Mean HbA₁(c) values were 9.5% before insulin initiation, 8.1% at visit 2 (median 1.2 years later), and 7.9% at visit 3 (median 3.9 years after initiation). Mean insulin dose was 24 units at initiation, 48 units at visit 2, and 65 units at visit 3. At visit 3, 20% of patients continued to have very poor glycemic control (HbA₁(c) > 9.0%). With the exception of a decrease in sulfonylurea use, concomitant use of oral antihyperglycemic agents remained static over time.
conclusionEven in patients identified as being sufficiently high risk to warrant insulin therapy, a clinical care gap exists in physician efforts to achieve and sustain recommended HbA₁(c) target levels. Family physicians need strategies to facilitate earlier initiation and ongoing intensification of insulin therapy.
Indexed as
Identifiers
21156883PMC3001949W2122636384What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.