Clinical inertia with regard to intensifying therapy in people with type 2 diabetes treated with basal insulin

• DOI: 10.1111/dom.12626
• Publication Date: 2016-01-08T08:03:24Z
• Authors: K. Khunti; A. Nikolajsen; B. L. Thorsted; M. Andersen; M. J. Davies; S. K. Paul
• Keywords: Basal (medicine); Regimen; Tolerability

Aim To investigate whether clinical inertia, the failure to intensify treatment regimens when required, exists in people with type 2 diabetes treated basal insulin. Methods This was a retrospective cohort study involving patients UK Clinical Practice Research Datalink database between January 2004 and December 2011, follow-up until 2013. Results A total of 11 696 were included analysis. Among all patients, 36.5% had their intensified during period; these, 50.0, 42.5 7.4% bolus or premix insulin glucagon-like peptide-1 receptor agonists, respectively. The median time from initiation intensification 4.3 years [95% confidence interval (CI) 4.1, 4.6]. clinically eligible for [glycated haemoglobin (HbA1c) ≥7.5% (58 mmol/mol)], 30.9% regimen intensified. this group 3.7 (95% CI 3.4, 4.0). Increasing age, duration diabetes, oral antihyperglycaemic agent usage Charlson comorbidity index score associated significant delay (p < 0.05). HbA1c mmol/mol), 32.1% stopped therapy. Conclusions Strategies should be developed increase number undergoing therapy reduce intensifying suitable on Initiatives support continuing are also required.