Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study
<h3>Background</h3><p dir="ltr">Achieving and maintaining adequate glycaemic control is critical to reduce diabetes‐related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.</p><h3>Aim</h3><p dir="lt...
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2024
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| _version_ | 1864513542094323712 |
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| author | Mohammed Bashir (5593550) |
| author2 | Noora Al Thani (21842888) Abeer Khalid (21842891) Obada Khalil (21842894) Zaina Alamer (21842897) Mohammed Khair Hamad (21842900) Gowri Karuppasamy (21842903) Mohammed Abufaeid (21842906) Mutwakil Elbidairi (21842909) Dhabia Al‐Mohnnadi (21842912) Tarik Elhadd (5480393) Mahmoud Zirie (124704) |
| author2_role | author author author author author author author author author author author |
| author_facet | Mohammed Bashir (5593550) Noora Al Thani (21842888) Abeer Khalid (21842891) Obada Khalil (21842894) Zaina Alamer (21842897) Mohammed Khair Hamad (21842900) Gowri Karuppasamy (21842903) Mohammed Abufaeid (21842906) Mutwakil Elbidairi (21842909) Dhabia Al‐Mohnnadi (21842912) Tarik Elhadd (5480393) Mahmoud Zirie (124704) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mohammed Bashir (5593550) Noora Al Thani (21842888) Abeer Khalid (21842891) Obada Khalil (21842894) Zaina Alamer (21842897) Mohammed Khair Hamad (21842900) Gowri Karuppasamy (21842903) Mohammed Abufaeid (21842906) Mutwakil Elbidairi (21842909) Dhabia Al‐Mohnnadi (21842912) Tarik Elhadd (5480393) Mahmoud Zirie (124704) |
| dc.date.none.fl_str_mv | 2024-06-06T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1002/edm2.495 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Insulin_Inertia_Among_People_With_Type_2_Diabetes_Mellitus_in_Qatar_The_INERT_Q_Study/29716397 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Health sciences Epidemiology Health services and systems insulin therapy therapeutic inertia Type 2 diabetes mellitus |
| dc.title.none.fl_str_mv | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">Achieving and maintaining adequate glycaemic control is critical to reduce diabetes‐related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.</p><h3>Aim</h3><p dir="ltr">To assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM‐2).</p><h3>Methods</h3><p dir="ltr">We performed a retrospective longitudinal cohort study and followed DM‐2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year.</p><h3>Results</h3><p dir="ltr">We included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM‐2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at −2nd year and −1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4–9.6] <i>p</i> < 0.001) and (OR 6.2 [3.2–12.0], <i>p</i> < 0.001), respectively.</p><h3>Conclusion</h3><p dir="ltr">In people with DM‐2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.</p><h2>Other Information</h2><p dir="ltr">Published in: Endocrinology, Diabetes & Metabolism<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/edm2.495" target="_blank">https://dx.doi.org/10.1002/edm2.495</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_fd8ece427f167759f666f1c540d7fc5f |
| identifier_str_mv | 10.1002/edm2.495 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/29716397 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q StudyMohammed Bashir (5593550)Noora Al Thani (21842888)Abeer Khalid (21842891)Obada Khalil (21842894)Zaina Alamer (21842897)Mohammed Khair Hamad (21842900)Gowri Karuppasamy (21842903)Mohammed Abufaeid (21842906)Mutwakil Elbidairi (21842909)Dhabia Al‐Mohnnadi (21842912)Tarik Elhadd (5480393)Mahmoud Zirie (124704)Biomedical and clinical sciencesClinical sciencesMedical biochemistry and metabolomicsHealth sciencesEpidemiologyHealth services and systemsinsulin therapytherapeutic inertiaType 2 diabetes mellitus<h3>Background</h3><p dir="ltr">Achieving and maintaining adequate glycaemic control is critical to reduce diabetes‐related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control.</p><h3>Aim</h3><p dir="ltr">To assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM‐2).</p><h3>Methods</h3><p dir="ltr">We performed a retrospective longitudinal cohort study and followed DM‐2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year.</p><h3>Results</h3><p dir="ltr">We included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM‐2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at −2nd year and −1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4–9.6] <i>p</i> < 0.001) and (OR 6.2 [3.2–12.0], <i>p</i> < 0.001), respectively.</p><h3>Conclusion</h3><p dir="ltr">In people with DM‐2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.</p><h2>Other Information</h2><p dir="ltr">Published in: Endocrinology, Diabetes & Metabolism<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1002/edm2.495" target="_blank">https://dx.doi.org/10.1002/edm2.495</a></p>2024-06-06T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1002/edm2.495https://figshare.com/articles/journal_contribution/Insulin_Inertia_Among_People_With_Type_2_Diabetes_Mellitus_in_Qatar_The_INERT_Q_Study/29716397CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/297163972024-06-06T03:00:00Z |
| spellingShingle | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study Mohammed Bashir (5593550) Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Health sciences Epidemiology Health services and systems insulin therapy therapeutic inertia Type 2 diabetes mellitus |
| status_str | publishedVersion |
| title | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| title_full | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| title_fullStr | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| title_full_unstemmed | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| title_short | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| title_sort | Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT‐Q Study |
| topic | Biomedical and clinical sciences Clinical sciences Medical biochemistry and metabolomics Health sciences Epidemiology Health services and systems insulin therapy therapeutic inertia Type 2 diabetes mellitus |