engleski

Type 2 diabetes patient profile at initiation of insulin therapy: croatian single-center cross sectional study.

The aim of the study was to determine timing of insulin initiation in type 2 diabetes mellitus (T2DM) patients in routine clinical practice, especially in relation to glycemic control, use of oral antidiabetic drugs (OADs) and status of chronic diabetic complications. The study used data obtained from medical records related to clinical characteristics of T2DM patients starting insulin treatment at a secondary/tertiary care setting of the Regional Center for Diabetes, Endocrinology and Metabolic Diseases in Osijek, Osijek-Baranja County, eastern Croatia. The following data were collected on 499 consecutive patients: age median 63 years, 40% male, median T2DM duration 10 years and mean body mass index 29.7 kg/m2. Preinsulin HbA1c was 10%. The proportion of patients with HbA1c >9.0% was 71.0%. Pre-insulin OAD treatment included sulfonylureas (81.8%), metformin (51.6%), dipeptidyl peptidase 4 (DPP-IV) inhibitors (26.2%), glucagon-like peptide-1 (GLP-1) analogues (1.3%), glinides (2.7%) and thiazolidinediones (0.8%). Chronic diabetic complications were evident in the majority of patients (88.8%) at the time of insulin therapy initiation. In conclusion, despite well-documented benefits of timely glycemic control and consensus guidelines encouraging earlier use of insulin, there still is considerable clinical inertia. These findings are representative for the eastern part of Croatia and should encourage new studies in the field in other parts of the country.

clinical inertia, insulin therapy, oral antidiabetic drug therapy, treatment guidelines, type 2 diabetes mellitus

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