Factors influencing initial choice of insulin therapy in a large international non-interventional study of people with type 2 diabetes
Factors influencing initial choice of insulin therapy in a large international non-interventional study of people with type 2 diabetes
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DOI：
10.1111/j.1463-1326.2012.01613.x
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发表时间：
2012-10-01
影响因子：
5.8
通讯作者：
Home, P. D.
中科院分区：
文献类型：
--
作者：
Freemantle, N.;Balkau, B.;Home, P. D.
目的：使用基线特征的心血管风险评估的人与2型糖尿病胰岛素治疗研究人群，以确定因素，可以解释选择胰岛素治疗时开始insulin.Methods：源，非干预性，纵向，长期研究涉及314个中心在12个国家在5个地区。在过去12个月内开始任何胰岛素治疗方案的人被招募。结果：参与者（N = 3031）平均年龄62岁，糖尿病病程11年，体重指数29.3 kg/m2，糖化血红蛋白9.5%。与其他地区的受试者相比，日本的受试者高血压较少，吸烟较多，合并用药较少。在日本，只有医生所在地（农村或城市）影响胰岛素的选择。在其他四个地区相结合，医生的位置，专业，性别和实践类型影响胰岛素的选择，参与者的位置，基线HbA 1c，使用降糖治疗和以前的胰岛素促分泌素use.Conclusion：最初的胰岛素治疗方案的选择是由几个医生和参与者的特点在加拿大和欧洲，但只有在日本的医生位置的影响。
Aim: To use baseline characteristics of the Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy study population to identify factors that could explain the choice of insulin therapy when beginning insulin.Methods: The source, non-interventional, longitudinal, long-term study involves 314 centres in 12 countries in five regions. People were enrolled having started any insulin regimen in the previous 12 months. To identify factors associated with the choice of insulin regimen, multivariable backward logistic regression was performed on eligible physician and participant explanatory variables.Results: Participants (N = 3031) had mean age 62 years, diabetes duration 11 years, body mass index 29.3 kg/m(2) and an HbA1c of 9.5%. Participants in Japan had less hypertension, smoked more and used fewer concomitant medications than those of other regions. Only physician location (rural or urban) influenced the choice of insulin in Japan. In the other four-regions-combined, physician location, specialty, sex and practice type influenced choice of insulin as did participant location, baseline HbA1c, use of glucose-lowering therapies and prior insulin secretagogue use.Conclusion: Choice of initial insulin regimen was influenced by several physician and participant characteristics in Canada and Europe, but only by physician location in Japan.