TITLE

Initiation of insulin therapy in elderly patients taking oral antidiabetes drugs

AUTHOR(S)
Pérez, Norma; Moisan, Jocelyne; Sirois, Caroline; Poirier, Paul; Grégoire, Jean-Pierre
PUB. DATE
June 2009
SOURCE
CMAJ: Canadian Medical Association Journal;6/23/2009, Vol. 180 Issue 13, p1310
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: We sought to estimate the rate of initiation of insulin therapy among elderly patients using oral antidiabetes drugs and to identify the factors associated with this initiation. Methods: We conducted a population-based cohort study involving people aged 66 or more years who were newly dispensed an oral antidiabetes drug. Individuals who had received acarbose or a thiazolidinedione were excluded. The rate of insulin initiation was calculated by use of the Kaplan-Meier method. Factors associated with insulin initiation were identified by multivariable Cox regression analyses. Results: In this cohort of 69 674 new users of oral antidiabetes drugs, insulin was initiated at rate of 9.7 cases per 1000 patient-years. Patients who had initially received an insulin secretagogue (rather than metformin), who were prescribed an oral antidiabetes drug by an endocrinologist or an internist, who received higher initial doses of an oral antidiabetes drug, who received oral corticosteroids, used glucometer strips, or were admitted to hospital in the year before initiation of oral antidiabetes therapy, or who received 16 or more medications were more likely than those without these characteristics to have insulin therapy initiated. In contrast, patients who received thiazides or who used up to 12 medications (v. none) were less likely to have insulin therapy initiated. Interpretation: Several factors related to drugs and health services are associated with the initiation of insulin therapy in elderly patients receiving oral antidiabetes drugs. It is unclear whether these factors predict secondary failure of oral antidiabetes drugs or instead reflect better management of type 2 diabetes.
ACCESSION #
41784772

 

Related Articles

  • Insulin lispro taken at mealtime reduces hypoglycemic episodes.  // Geriatrics;Aug97, Vol. 52 Issue 8, p101 

    Focuses on insulin lispro, an insulin analog that appears to reduce the risk of hypoglycemia in older patients with type 2 diabetes. Research findings on the study of human insulin therapy; Proper way of administering insulin lispro to older patient with type 2 diabetes.

  • Exogenous insulin increased risk for complications, mortality in type 2 diabetes.  // Endocrine Today;Mar2013, Vol. 11 Issue 3, p24 

    The article reports on a study which found that exogenous insulin therapy is linked to an increased risk for diabetes-related complications, cancer and all-cause mortality among patients with type 2 diabetes.

  • Basal Insulin Therapy in Type 2 Diabetes. Rosenstock, Julio; Schwartz, Sherwyn L.; Clark Jr., Charles M.; Park, Glen D.; Donley, David W.; Edwards, Mike B. // Diabetes Care;Apr2001, Vol. 24 Issue 4, p631 

    Provides information on a study which determined the safety and efficacy of the long-acting analog insulin glargine compared with NPH insulin in patients with type 2 diabetes. Research design and methods; Results; Conclusions.

  • A comparative study of insulin lispro and human regular insulin in patients with type 2 diabetes mellitus and secondary failure of oral hypoglycemic agents.  // Clinical & Investigative Medicine;Dec2001, Vol. 24 Issue 6, p292 

    Presents information on a study which compared the effects of insulin lispro and human regular insulin on glycemic control, daily blood glucose profiles and rates of hypoglycemia in patients with type 2 diabetes mellitus after failure to respond to sulfonylurea drugs. Research design and...

  • Insulin.  // Reactions Weekly;8/7/2010, Issue 1313, p27 

    The article describes the case of a 48-year-old man who experienced two cutaneous amyloid tumors while being treated with recombinant human insulin for type 2 diabetes, referencing a study published in the March 2010 issue of the "Netherlands Journal of Medicine."

  • Mix It Up.  // Diabetes Forecast;Jan/Feb2016, Vol. 69 Issue 1, p15 

    The article offers suggestions for taking NPH ("N") intermediate-acting insulin and mentions similar results among type 2 diabetes patients after using NPH vials.

  • Insulin detemir.  // Reactions Weekly;5/15/2010, Issue 1301, p30 

    The article describes the case of a man who developed allergic skin reactions while receiving treatment with insulin detemir for type 2 diabetes mellitus.

  • Erratum.  // Diabetes Care;Dec2013, Vol. 36 Issue 12, p4172 

    A correction to the article "Combining Incretin-Based Therapies With Insulin: Realizing the Potential in Type 2 Diabetes" that was published in the journal in 2013 is presented.

  • Pharmacologic management of type 2 diabetes in the elderly: Overview of treatment... da Silva, Barbara A. // Formulary;Jul2000, Vol. 35 Issue 7, p580 

    Evaluates treatment options for type 2 diabetes in the elderly. Complications requiring special consideration in the elderly; Glycemic control techniques; Oral hypoglycemic medications; Combination therapy; Adverse effects; Drug interactions; Dosage administration.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics