Summary Objective To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Research design and methods Study of Once-Daily Levemir (SOLVE™) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. Results A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Conclusions Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation.

Orozco-Beltran, D., Pan, C., Svendsen, A. L., Faerch, L., Caputo, S., Basal insulin initiation in primary vs. specialist care: Similar glycaemic control in two different patient populations, <<INTERNATIONAL JOURNAL OF CLINICAL PRACTICE>>, 2016; 70 (3): 236-243. [doi:10.1111/ijcp.12776] [http://hdl.handle.net/10807/171216]

Basal insulin initiation in primary vs. specialist care: Similar glycaemic control in two different patient populations

Caputo, S.
2016

Abstract

Summary Objective To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Research design and methods Study of Once-Daily Levemir (SOLVE™) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. Results A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Conclusions Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation.
2016
Inglese
Orozco-Beltran, D., Pan, C., Svendsen, A. L., Faerch, L., Caputo, S., Basal insulin initiation in primary vs. specialist care: Similar glycaemic control in two different patient populations, <<INTERNATIONAL JOURNAL OF CLINICAL PRACTICE>>, 2016; 70 (3): 236-243. [doi:10.1111/ijcp.12776] [http://hdl.handle.net/10807/171216]
File in questo prodotto:
File Dimensione Formato  
171216OA.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 97.12 kB
Formato Adobe PDF
97.12 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/171216
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 4
social impact