Observational studyActa diabetologica2019
High level of clinical inertia in insulin initiation in type 2 diabetes across Central and South-Eastern Europe: insights from SITIP study.
Observational study in Acta diabetologica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Context factors in clinical decision-making: a scoping review.BMC medical informatics and decision making · 2025Article
- The Barriers to Insulin Therapy Initiation in Type 2 Diabetes Patients: A Study of General Practitioner Perceptions in Huinan Community in South Shanghai.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Diabetes Patients' Acceptance of Injectable Treatment, a Scientometric Analysis.Life (Basel, Switzerland) · 2022Review
- Weight Change and the Association with Adherence and Persistence to Diabetes Therapy: A Narrative Review.Patient preference and adherence · 2022Review
- Uptake of new antidiabetic medicines in 11 European countries.BMC endocrine disorders · 2021Article
- Expert Opinion: A Call for Basal Insulin Titration in Patients with Type 2 Diabetes in Daily Practice: Southeast European Perspective.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Physician related barriers towards insulin therapy at primary care centres in Trinidad: a cross-sectional study.BMC family practice · 2020Article
- Clinical inertia is the enemy of therapeutic success in the management of diabetes and its complications: a narrative literature review.Diabetology & metabolic syndrome · 2020Review
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Authors and funding
8 authors at 6 institutions in 5 countries.
Funding
Abstract
aimsLittle is known regarding initiation of insulin therapy in type 2 diabetes (T2D) in Central and South-Eastern European countries. Therefore, we conducted a survey to characterise the prescribing practices of specialist diabetes healthcare professionals in this region and assessed factors that influence clinical decision-making regarding insulin initiation in T2D.
methodsA cross-sectional survey sampled 211 specialist diabetes healthcare prescribers from five Central and South-Eastern European countries (Bulgaria, Croatia, Greece, Hungary, and Slovenia). A structured questionnaire was developed which surveyed current clinical practices and influencing factors, barriers to insulin initiation, and combination therapy prescribing preferences.
resultOnly 9.4% (20 of out of 211 respondents) of healthcare professionals would initiate insulin therapy in T2D patients at the recommended HbA1c threshold of 7-7.9% [53-63 mmol/mol]. Large regional differences were evident in insulin initiation thresholds (≥ 9.0% [≥ 75 mmol/mol]: Bulgaria 80.8% vs. Slovenia 13.3%). Psychological distress was recorded as the major barrier to insulin initiation. Health insurance regulations were ranked more important than personal clinical experience and clinical guidelines in clinical decision-making. Information from peers was more influential than manufacturer information, clinical experience, and continuous medical education, respectively, for insulin initiation.
conclusionsDespite large regional variation, there is widespread delay of insulin initiation from specialist diabetes healthcare professionals in Central and South-Eastern Europe.
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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 Socratic graph.