Evidence mapPaperPMID 38844642Full record

ArticleEndocrinology, diabetes & metabolism2024

Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT-Q Study.

Mohammed Bashir, Noora Al Thani, Abeer Khalid, Obada Khalil, Zaina Alamer, Mohammed Khair Hamad, Gowri Karuppasamy, Mohammed Abufaeid, Mutwakil Elbidairi, Dhabia Al-Mohnnadi and 2 more

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Article in Endocrinology, diabetes & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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12 authors.

Mohammed BashirEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0003-3096-2641
Noora Al ThaniEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Abeer KhalidEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Obada KhalilEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0003-3186-7240
Zaina AlamerEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mohammed Khair HamadEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0001-9739-0073
Gowri KaruppasamyEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mohammed AbufaeidEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mutwakil ElbidairiDepartment of Pharmacy, Hamad Medical Corporation, Doha, Qatar.
Dhabia Al-MohnnadiEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Tarik ElhaddEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Mahmoud ZirieEndocrine Section, Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAchieving and maintaining adequate glycaemic control is critical to reduce diabetes-related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.

aimTo assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM-2).

methodsWe performed a retrospective longitudinal cohort study and followed DM-2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year.

resultsWe included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM-2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at -2nd year and -1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4-9.6] p < 0.001) and (OR 6.2 [3.2-12.0], p < 0.001), respectively.

conclusionIn people with DM-2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.

Indexed as

Diabetes Mellitus, Type 2Glycated HemoglobinHypoglycemic AgentsInsulinAdultAgedBlood GlucoseFemaleGlycemic ControlHumansLongitudinal StudiesMaleMiddle AgedQatarRetrospective StudiesBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulininsulin therapytherapeutic inertiaType 2 diabetes mellitus

Identifiers

PMID38844642
PMCPMC11156521

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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.