Insulin therapy initially declined and delayed by an average of two years

September 14, 2017
insulin
High-resolution model of six insulin molecules assembled in a hexamer. Credit: Isaac Yonemoto/Wikipedia

Although delaying insulin therapy leads to a worsening progression of diabetes, new research by Brigham and Women's Hospital has found 30 percent of type 2 diabetic patients don't begin insulin, a medication used to lower the body's blood sugar levels, when it's initially recommended, with the average start time being two years later. These findings were published today in the journal of Diabetic Medicine.

Alexander Turchin, MD, MS, director of quality in diabetes in the division of endocrinology, diabetes and hypertension at BWH, who led the study, was inspired by his own practice as an endocrinologist treating .

"Unfortunately this isn't uncommon, patients being reluctant to start insulin therapy when it's recommended," says Turchin. "Many clinicians have encountered this phenomenon, but until our study it was not known just how prevalent delays in insulin initiation are. As physicians, we need to make sure that these patients are making fully informed decisions and that we understand their perspective to ensure they are treated effectively."

To find this information, investigators designed a computer program to analyze electronic physician notes of BWH patients from 2000 to 2014 to identify patients with type 2 diabetes who initially declined insulin therapy. Of the 3,295 patients included in the analysis, nearly one third declined a physician's advice to begin insulin at the time the recommendation was made. People who initially declined, but ultimately accepted the recommendation to start insulin, on average, started the insulin therapy more than two years later, during which time their had increased further.

Diabetes is increasingly common in the United States, with over 30 million people affected. The high prevalence of decline of by patients that the study found suggests, per the researcher's estimations, that it could mean over 1 million people in the U.S. find themselves in this situation. The team notes further investigation is needed to determine the reasons, risk factors and long-term outcomes of these ' important clinical decision.

Explore further: Transforming skin cells to insulin

More information: Turchin et al. "Decline of insulin therapy and delays in insulin initiation in people with uncontrolled diabetes mellitus". Diabetic Medicine , DOI: 10.1111/dme.13454

Related Stories

Transforming skin cells to insulin

August 9, 2017
Researchers at the University of Bergen have transformed skin puncture cells from diabetes patients into insulin producing cells, using stem cell techniques. The researchers' aim is to transplant these cells under the skin ...

ADA recommends metformin as the preferred drug treatment for type 2 diabetes

March 13, 2017
The American Diabetes Association (ADA) recommends metformin as the first-line treatment for type 2 diabetes. Metformin monotherapy should be initiated at the time of diagnosis for most patients unless there are contraindications. ...

Many diabetes patients produce some insulin

June 22, 2017
Some insulin is still produced in almost half of patients that have had type 1 diabetes for more than ten years. The study conducted by researchers at Uppsala University in Sweden has now been published online by the medical ...

Home monitoring of blood sugar did not improve glycemic control after one year

June 10, 2017
Self-monitoring of blood glucose levels in patients with type 2 diabetes who are not treated with insulin did not improve glycemic control or health-related quality of life after one year in a randomized trial, results that ...

Diabetes requiring insulin tied to increased stroke risk in A-fib

January 26, 2017
(HealthDay)—For patients with atrial fibrillation (AF), diabetes requiring insulin, but not diabetes without insulin treatment, is associated with an increased risk of stroke/systemic embolism, according to a study published ...

Recommended for you

Pre-diabetes discovery marks step towards precision medicine

November 20, 2017
Researchers from the University of Sydney's Charles Perkins Centre have identified three specific molecules that accurately indicate insulin resistance, or pre-diabetes - a major predictor of metabolic syndrome, the collection ...

Scientists reverse diabetes in a mouse model using modified blood stem cells

November 15, 2017
Researchers at Boston Children's Hospital have successfully reversed type 1 diabetes in a mouse model by infusing blood stem cells pre-treated to produce more of a protein called PD-L1, which is deficient in mice (and people) ...

Pregnancy-related conditions taken together leave moms—and dads—at risk

November 14, 2017
Research has already shown that women who develop either diabetes or high blood pressure during pregnancy are at risk of getting type 2 diabetes, high blood pressure or heart disease years later. Now, a new study from a team ...

Study reveals how a very low calorie diet can reverse type 2 diabetes

November 9, 2017
In a new study, a Yale-led research team uncovers how a very low calorie diet can rapidly reverse type 2 diabetes in animal models. If confirmed in people, the insight provides potential new drug targets for treating this ...

Targeting a microRNA shows potential to enhance effectiveness of diabetes drugs

November 7, 2017
Over the past 15 years, University of Alabama at Birmingham endocrinologist Anath Shalev, M.D., has unraveled a crucial biological pathway that malfunctions in diabetes.

Researchers link Western diet to vascular damage and prediabetes

October 31, 2017
Could short-term exposure to the average American diet increase one's risk for developing diabetes and cardiovascular disease? According to a recent study funded by the American Heart Association (AHA), researchers from New ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.