ArticleClinical diabetes and endocrinology2021
Reasons for discontinuing insulin and factors associated with insulin discontinuation in patients with type 2 diabetes mellitus: a real-world evidence study.
Article in Clinical diabetes and endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- Natural language processing to enhance rheumatoid arthritis care in clinical studies: a scoping review of applications, data, approaches, challenges and future directions.Rheumatology international · 2026Article
- Impact of Real-Time Continuous Glucose Monitoring on Medication Use and Glycemic Control in Type 2 Diabetes Across Therapy Regimens.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- What Is the Role of Basal Weekly Insulin in Clinical Practice? The State of the Art.Biomedicines · 2024Review
- Patient perceptions of insulin therapy in diabetes self-management with insulin injection devices.Acta diabetologica · 2023Article
- Recommended practices and ethical considerations for natural language processing-assisted observational research: A scoping review.Clinical and translational science · 2023Article
- Weight Change and the Association with Adherence and Persistence to Diabetes Therapy: A Narrative Review.Patient preference and adherence · 2022Review
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEvidence suggests that insulin therapy of patients with type 2 diabetes mellitus (T2DM) is frequently discontinued. However, the reasons for discontinuing insulin and factors associated with insulin discontinuation in this patient population are not well understood.
methodsWe conducted a retrospective cohort study of adults with T2DM prescribed insulin between 2010 and 2017 at Partners HealthCare. Reasons for discontinuing insulin and factors associated with insulin discontinuation were studied using electronic medical records (EMR) data. Natural language processing (NLP) was applied to identify reasons from unstructured clinical notes. Factors associated with insulin discontinuation were extracted from structured EMR data and evaluated using multivariable logistic regression.
resultsAmong 7009 study patients, 2957 (42.2%) discontinued insulin within 12 months after study entry. Most patients who discontinued insulin (2121 / 71.7%) had reasons for discontinuation documented. The most common reasons were improving blood glucose control (33.2%), achieved weight loss (18.5%) and initiation of non-insulin diabetes medications (16.7%). In multivariable analysis adjusted for demographics and comorbidities, patients were more likely to discontinue either basal or bolus insulin if they were on a basal-bolus regimen (OR 1.6, 95% CI 1.3 to 1.8; p < 0.001) or were being seen by an endocrinologist (OR 2.6; 95% CI 2.2 to 3.0; p < 0.001).
conclusionsIn this large real-world evidence study conducted in an area with a high penetration of health insurance, insulin discontinuation countenanced by healthcare providers was common. In most cases it was linked to achievement of glycemic control, achieved weight loss and initiation of other diabetes medications. Factors associated with and stated reasons for insulin discontinuation were different from those previously described for non-adherence to insulin therapy, identifying it as a distinct clinical phenomenon.
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