Open AccessPresent status of insulin therapy for type 2 diabetes treated by general practitioners and diabetes specialists in Japan: Third report of a cross‐sectional survey of 15,652 patients
Author(s) -
Arai Keiko,
Takai Masahiko,
Hirao Koichi,
Matsuba Ikuro,
Matoba Kiyokazu,
Takeda Hiroshi,
Kanamori Akira,
Yamauchi Mikio,
Mori Hisao,
Terauchi Yasuo
Publication year - 2012
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/j.2040-1124.2012.00198.x
Subject(s) - medicine , insulin , glycemic , diabetes mellitus , type 2 diabetes , glycated hemoglobin , type 1 diabetes , regimen , endocrinology
Aims/Introduction: Insulin therapy is often required to achieve good glycemic control in patients with type 2 diabetes mellitus. However, some providers, particularly general practitioners (GPs), are reluctant to prescribe insulin to their patients. The aim of the present study was to clarify any differences in, as well as any problems associated with, insulin therapy in patients with type 2 diabetes being treated by either a GP or a diabetes specialist in Japan. Materials and Methods: Of 15,652 patients across 721 clinics and hospitals, 15,350 were diagnosed with type 2 diabetes (14,312 by GPs and 1038 by specialists). Data regarding glycated hemoglobin (HbA 1c ) levels, age, height, bodyweight and treatment modality were collected for each patient. Results: Of the patients with type 2 diabetes, 9.1 and 22.9% had been prescribed insulin monotherapy, and 38.8 and 37.0% were also receiving insulin with an oral antidiabetic (OAD) by GPs or specialists, respectively. Diabetes specialists prescribed analog insulin more frequently than did GPs. GPs chose premixed insulin more frequently than did specialists, and this factor correlated with higher HbA 1c levels. A younger age and daily insulin dose in groups being treated by both providers were correlated with high HbA 1c levels on insulin monotherapy. Neither type of insulin nor OAD was correlated with HbA 1c on insulin plus OAD therapy. Conclusions: To achieve better glycemic control with insulin therapy, sufficient insulin dose and intensive treatment regimen, in addition to lifestyle interventions, might be necessary. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00198.x, 2012)