Overview of Therapeutic Inertia in Diabetes: Prevalence, Causes, and Consequences

Karam, Susan; Dendy, Jared; Polu, Shruti; Blonde, Lawrence

doi:10.2337/ds19-0029

Cited by 35 publications

(33 citation statements)

References 66 publications

(71 reference statements)

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“…While this study presents population-level findings, more research focusing on specific reasons for TI in the holistic management of glycaemic and cardiovascular risk factors in the primary care setting is much needed. 37,38 This study has several strengths, including the use of nationally representative population-based data with a mean of 5 years of follow-up, the QOF-influenced recording of disease events with dates of events, and the identification of people with T2DM using a robust clinically guided machine-learning approach, thus reducing bias attributable to under-identification and misclassification. 33 While the condition of being registered in the database for at least 6 months prior to diabetes diagnosis introduces some selection bias, such restriction reduces prevalent case inclusion in our study cohort.…”

Section: Discussionmentioning

confidence: 99%

“…This unique finding was reflected across all age groups, suggesting the need to revise the current guideline(s) on better assessment and stratification of primary prevention of people with high and low ASCVD risk at diagnosis, and to redefine the proactive pharmacological therapeutic intervention for blood pressure and lipid control. While this study presents population‐level findings, more research focusing on specific reasons for TI in the holistic management of glycaemic and cardiovascular risk factors in the primary care setting is much needed 37,38 …”

Section: Discussionmentioning

confidence: 99%

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Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Ling

Montvida

Khunti

et al. 2021

Diabetes Obesity Metabolism

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Objective: To investigate trends in the prevalence of hypertension and dyslipidaemia in incident type 2 diabetes (T2DM), time to antihypertensive (AHT) and lipid-lowering therapy (LLT), and the association with systolic blood pressure (SBP) and lipid control.Research Design and Methods: Using The Health Improvement Network UK primary care database, 254 925 people with incident T2DM and existing dyslipidaemia or hypertension were identified. Among those without atherosclerotic cardiovascular disease (ASCVD) history and not on AHT or LLT at diagnosis, the adjusted median months to initiating an AHT or an LLT, and the probabilities of high SBP or lipid levels over 2 years in people initiating therapy within or after 1 year were evaluated according to high and low ASCVD risk status.Results: At diabetes diagnosis, 66% and 66% had dyslipidaemia and hypertension, respectively. During 2005 to 2016, dyslipidaemia prevalence increased by 10% in people aged <60 years, while hypertension prevalence remained stable in all age groups. Among those with high ASCVD risk status in the age groups 18 to 39, 40 to 49, and 50 to 59 years, the median number of months to initiation of therapy were 20.4

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Ling

Montvida

Khunti

et al. 2021

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Среди сахароснижающих препаратов инсулин обладает наибольшей эффективностью (снижение HbA1c на 3% и более) и при условии титрации дозы позволяет в самые короткие сроки добиться целевого контроля гликемии [11][12][13].…”

Section: проблемы инсулинотерапии и пути их решения при сахарном диабете 2-го типаunclassified

“…терапии -период наиболее активной титрации дозы инсулина. Титрация инсулина в реальных условиях часто ограничивается риском развития гипогликемии [10,13]. Значимое преимущество гларгина 300 ЕД/мл -снижение риска гипогликемий в этот период лечения при сопоставимой эффективности по сравнению с гларгином 100 ЕД/мл -имеет практическое значение, поскольку позволяет безопасно титровать дозу инсулина и достигать целевого контроля гликемии большему числу пациентов с СД 2-го типа.…”

Section: доказательная база эффективности и безопасности гларгина 300 ед/млunclassified

Long-acting insulin analogue in the treatment of type 2 diabetes mellitus: emphasis on proven efficacy and safety

2021

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In time, prescription of insulin therapy (IT) becomes inevitable for many patients with type 2 diabetes mellitus (DM) to achieve and maintain the target hypoglycemic range.According to the current guidelines, the addition of basal insulin to glucose-lowering therapy in patients with insufficient control of type 2 diabetes, gradual titration of its dose in accordance with a fasting blood glucose level is an effective and safe method for initiating IT. The properties of modern long-acting insulin analogues are considered. Glargine 300 U/ml is a modern analogue of long-acting insulin that is intended to be used once a day. The glargine molecule forms the basis of the drug. Increasing the concentration of glargine per volume unit and formation of a smaller subcutaneous depot led to a change in the pharmacokinetic properties of the drug. Glargine 300 IU/ml provides a more stable, long-term, predictable action with low glycemic variability as compared with glargine 100 IU/ml, which reduces the risk of hypoglycemia. The sugar-reducing efficacy and safety of insulin glargine 300 U/ml as evidenced by the findings of the international clinical phase III EDITION studies are discussed. Insulin glargine 300 U/ml showed a similar decrease in HbA1c levels compared to insulin glargine 100 U/ml with an improved safety profile (lower risk of developing episodes of confirmed or severe hypoglycemia at all times of the day, including the nighttime) and a less pronounced effect on the body weight of patients with type 2 diabetes. The efficacy and safety of the use of glargine 300 U/ml has been confirmed in type 2 diabetes patients with chronic kidney disease and the elderly. In the BRIGHT study, glargine 300 U/ml showed comparable glycemic control when it is being compared.

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“…Diabetes is becoming a public health problem as the improvement of people's living standards and the changes of their lifestyles. [ 1 ] Globally, the number of people with diabetes is reported to have reached 382 million in 2013, and that number will exceed 592 million by 2035. With a prevalence rate of 9.7%, China has become the fastest growing region of diabetes in the world and the world's largest diabetes country.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness and safety of recombinant human growth hormone combined with alginate dressing in the treatment of diabetic foot ulcer

Zhou¹,

Deng²,

Pu³

et al. 2021

Medicine

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Background: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes. It is the result of a joint effect of lower extremities vascular lesions, neuropathy, and infection, which require amputation and even threaten the life of the patient. At present, the conventional treatment for DFU includes infection control, wound care, wound reduction, reduction of foot pressure, use of dressings that are beneficial to wound surface healing, etc, but the effectiveness is not satisfactory. Recombinant human growth hormone and alginate dressing have been used in clinical, but there is lack of the relevant evidence of its effectiveness and safety, so this study evaluates the clinical effectiveness and safety of recombinant human growth hormone combined with alginate dressing in the treatment of DFU by systematic evaluation, the purpose is to provide a theoretical basis for the treatment of diabetic foot ulcer. Methods: This study mainly retrieves the randomized controlled trial of recombinant human growth hormone combined alginate dressing in the treatment of DFU in 7 electronic databases, such as PubMed, EMbase, Cochrane Library, SinoMed, CNKI, WANGFANG database, and VIP database. All the retrieval dates of database are from the establishment of the database until May 31, 2020. At the same time, searching the related degree papers, conference papers, and other gray literature by manual. The original literature data are independently screened and extracted by 2 researchers on the basis of inclusion and exclusion criteria and literature information sheets, and cross-checked and resolved through group discussions and consultations when there are differences of the opinion. Assessing the methodological quality of inclusion in the study based on the “Bias Risk Assessment Form” of the Cochrane Collaboration Network. Using the software of RevMan 5.3.3 and STATA 13.0 for statistical analysis. Results: This study compares the main and secondary outcome indicators by systematic evaluation and it will provide strong evidence of recombinant human growth hormone combined alginate dressing in the treatment of DFU. Ethics and dissemination: All data in this study are obtained through the web database and do not involve humans, so ethical approval is not suitable for this study. OSF registration number: DOI 10.17605/OSF.IO/W6P24. Conclusion: This study will give positive conclusions about the effectiveness and safety of recombinant human growth hormone combined alginate dressing in the treatment of DFU.

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Overview of Therapeutic Inertia in Diabetes: Prevalence, Causes, and Consequences

Cited by 35 publications

References 66 publications

Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Long-acting insulin analogue in the treatment of type 2 diabetes mellitus: emphasis on proven efficacy and safety

The effectiveness and safety of recombinant human growth hormone combined with alginate dressing in the treatment of diabetic foot ulcer

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