Delay of insulin initiation in patients with type 2 diabetes mellitus inadequately controlled with oral hypoglycemic agents (analysis of patient- and physician-related factors): A prospective observational DIPP-FACTOR study in Korea
- Authors
- Kim, Sin Gon; Kim, Nam Hoon; Ku, Bon Jeong; Shon, Ho Sang; Kim, Doo Man; Park, Tae Sun; Kim, Yong-Seong; Kim, In Joo; Choi, Dong Seop
- Issue Date
- 5월-2017
- Publisher
- WILEY
- Keywords
- Insulin therapy; Physician and patient behaviors; Type 2 diabetes
- Citation
- JOURNAL OF DIABETES INVESTIGATION, v.8, no.3, pp.346 - 353
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF DIABETES INVESTIGATION
- Volume
- 8
- Number
- 3
- Start Page
- 346
- End Page
- 353
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/83552
- DOI
- 10.1111/jdi.12581
- ISSN
- 2040-1116
- Abstract
- Aims/Introduction: To assess the time to initiation of insulin therapy, and concurrently investigate both patient- and physician-related factors associated with delaying insulin therapy in Korean patients with type 2 diabetes uncontrolled by oral hypoglycemic agents (OHAs). Materials and Methods: This prospective, observational disease registry study was carried out across 69 centers in Korea. Type 2 diabetes patients who had received two or more OHAs within the past 5 years, had a glycated hemoglobin 8% in the past 6 months and had not received insulin were included. Data recorded on data collection forms during a 12-month period were analyzed. Results: Of 2168 patients enrolled, 1959 were evaluated and classified as the insulin-initiated or insulin-delayed group. Insulin was prescribed for just 20% of the patients during a 1-year follow-up period, and less than half (44.5%) of the patients who were taking two OHAs started insulin after 6 years. Patient-related factors for delay in insulin initiation included older age, shorter duration of diabetes and lower glycated hemoglobin. Physician-related factors included age (similar to 50 to <60 years), sex (women) and number (<1000) of patients consulted per month. Patient refusal (33.6%) and physicians' concerns of patient non-compliance (26.5%) were the major physician-reported reasons for delaying insulin therapy. Inconvenience of insulin therapy (51.6%) and fear of injection (48.2%) were the major reasons for patient refusal. Conclusions: Insulin initiation is delayed in patients with type 2 diabetes uncontrolled by two or more OHAs in Korea. Patient- and physician-related factors associated with this delay need to be addressed for better diabetes management.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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