2017
DOI: 10.1111/dom.13064
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Insights into optimal basal insulin titration in type 2 diabetes: Results of a quantitative survey

Abstract: AimsBasal insulin (BI) treatment initiation and dose titration in type 2 diabetes (T2DM) are often delayed. Such “clinical inertia” results in poor glycaemic control and high risk of long‐term complications. This survey aimed to determine healthcare professional (HCP) and patient attitudes to BI initiation and titration.MethodsAn online survey (July–August 2015) including HCPs and patients with T2DM in the USA, France and Germany. Patients were ≥18 years old and had been on BI for 6 to 36 months, or discontinu… Show more

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Cited by 61 publications
(100 citation statements)
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“…This combined with lower levels of hypoglycaemia seen in Gla‐300 switchers may contribute to better persistence, as patients who are concerned about hypoglycaemia are more likely to discontinue their insulin therapy. In addition, both patients who are not achieving their A1C targets, and their physicians, cite hypoglycaemia as a barrier to effective insulin titration …”
Section: Discussionsupporting
confidence: 80%
“…This combined with lower levels of hypoglycaemia seen in Gla‐300 switchers may contribute to better persistence, as patients who are concerned about hypoglycaemia are more likely to discontinue their insulin therapy. In addition, both patients who are not achieving their A1C targets, and their physicians, cite hypoglycaemia as a barrier to effective insulin titration …”
Section: Discussionsupporting
confidence: 80%
“…Achieving glycated haemoglobin (HbA1c) targets reduces the risk of long‐term complications of diabetes, but in real‐world practice many individuals with type 2 diabetes (T2DM) fail to achieve adequate glycaemic control . Poor glycaemic control can be a result of clinical inertia, which may be contributed to by several physician‐ and patient‐related barriers including fear of hypoglycaemia and/or weight gain, burdensome treatment regimens, poor persistence to injectable therapies, lack of time for healthcare professionals to teach and difficulty for patients to understand the importance and performance of appropriate titration, frustration at time taken to achieve goals, insufficient communication between healthcare professionals and patients, and anxiety . As the disease progresses, lack of glycaemic control may also indicate the need to initiate adjunctive therapies…”
Section: Introductionmentioning
confidence: 99%
“…[2][3][4] Poor glycaemic control can be a result of clinical inertia, which may be contributed to by several physician-and patient-related barriers including fear of hypoglycaemia and/or weight gain, burdensome treatment regimens, poor persistence to injectable therapies, lack of time for healthcare professionals to teach and difficulty for patients to understand the importance and performance of appropriate titration, frustration at time taken to achieve goals, insufficient communication between healthcare professionals and patients, and anxiety. [5][6][7][8][9][10] As the disease progresses, lack of glycaemic control may also indicate the need to initiate adjunctive therapies. 11 Empowering those with T2DM to take a more active role in their own treatment may help individuals to achieve their glycaemic goals and reduce the risk of all-cause mortality, 12,13 which could reduce lifetime costs of complications and hospital admissions, 14 and might help to address the increasing burden of diabetes on healthcare systems worldwide.…”
Section: Introductionmentioning
confidence: 99%
“…Among patients with type 2 diabetes who initiate BI, only about 30% achieve their individual glycaemic target, primarily because a fear of hypoglycaemia limits proper titration . Additionally, patients who are concerned about hypoglycaemia are more likely to discontinue their insulin therapy …”
Section: Introductionmentioning
confidence: 99%