Basal insulin initiation in primary vs. specialist care: Similar glycaemic control in two different patient populations

Salvatore Caputo, D. Orozco-Beltran, C. Pan, A. L. Svendsen, L. Færch

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)

Abstract

Summary Objective To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Research design and methods Study of Once-Daily Levemir (SOLVE™) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. Results A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Conclusions Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation.
Lingua originaleEnglish
pagine (da-a)236-243
Numero di pagine8
RivistaInternational Journal of Clinical Practice
Volume70
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Aged
  • Blood Glucose
  • Diabetes Mellitus, Type 2
  • Drug Administration Schedule
  • Female
  • Humans
  • Hypoglycemia
  • Hypoglycemic Agents
  • Insulin Detemir
  • Logistic Models
  • Male
  • Middle Aged
  • Primary Health Care
  • Prospective Studies
  • Treatment Outcome

Fingerprint

Entra nei temi di ricerca di 'Basal insulin initiation in primary vs. specialist care: Similar glycaemic control in two different patient populations'. Insieme formano una fingerprint unica.

Cita questo