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Type 2 diabetes (T2DM) diagnoses are skyrocketing, making treatment of this disease an increasing focus of primary care visits. Guidelines recommend insulin intensification over time to achieve HbA1c targets. We conducted a systematic review regarding patterns and trends of insulin intensification and barriers to intensification. Providers across primary and specialty care settings often did not intensify insulin regimens despite patients' clinical status. Even among progressed patients, HbA1c values remained high. The paucity of available studies prevented a comprehensive understanding of patterns and trends in insulin intensification. Such information is needed to assess the quality of pharmacologic care for patients with T2DM.
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http://dx.doi.org/10.1016/j.pcd.2013.10.008 | DOI Listing |
BMJ Open Diabetes Res Care
September 2025
Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
Introduction: Adults with learning disabilities in the UK have a substantially higher risk of developing type 2 diabetes mellitus (T2DM) than the general population. This study aimed to assess the impact of living with learning disabilities on T2DM control, therapeutic management, vascular outcomes, and mortality in UK primary care.
Research Design And Methods: We conducted an observational cohort study using primary care electronic health records from the UK Clinical Practice Research Datalink.
Sci Rep
August 2025
School of Medicine, Tzu Chi University, Hualien, Taiwan.
The optimal timing for initiating insulin therapy in patients with type 2 diabetes (T2D) remains uncertain and varies among clinical guidelines. This retrospective cohort study analyzed claims data to include insulin-naïve T2D patients aged ≥ 20 years who intensified treatment using either insulin or non-insulin therapies between 2012 and 2021. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for major adverse cardiovascular events (MACE) and all-cause mortality, with adjustments for sex, age interval, index year interval, number of outpatient visits, number of inpatient admissions, diabetes duration, Charlson Comorbidity Index (CCI), Diabetes Complication Severity Index (DCSI), the number of prior antidiabetic medications, medications for hypertension, hyperlipidemia, antiplatelets, and anticoagulants.
View Article and Find Full Text PDFBiochimie
August 2025
Department of Physiological Sciences, State University of Londrina, Londrina, PR, 86051-990, Brazil. Electronic address:
Liver glycogen catabolism was investigated in young adult Goto-Kakizaki rats (GK group) and compared with non-diabetic Wistar rats (Control group). The diabetic condition of GK rats was confirmed by hyperglycemia and insulin resistance. Glycogen catabolism was intensified during the infusion of epinephrine (10 μM, 20 μM, and 40 μM), phenylephrine (2 μM, 4 μM, and 6 μM), and glucagon (1 nM) in both Control and GK livers.
View Article and Find Full Text PDFDiabetes Obes Metab
August 2025
Department of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California, USA.
Aims: The fixed-ratio combinations (FRCs) of a basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA), IDegLira (insulin degludec/liraglutide) and iGlarLixi (insulin glargine/lixisenatide), offer a once-daily injectable treatment option for adults with type 2 diabetes (T2D), combining complementary mechanisms of action to target both fasting and postprandial hyperglycaemia. While randomized controlled trials have demonstrated their efficacy and safety, real-world evidence (RWE) provides important insights into their effectiveness, tolerability and use across routine clinical practice.
Materials And Methods: This is a narrative review of selected real-world studies assessing the FRCs IDegLira and iGlarLixi in adults with T2D.
Acta Clin Belg
August 2025
Division of Endocrinology and Nutrition, Cliniques universitaires St-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
Objective: Continuous glucose monitoring (CGM) benefits type 2 diabetes (T2D) patients on multiple daily insulin injections (MDI), but its role in non-intensive insulin therapy remains underexplored. This study evaluates whether a short-term CGM non-blinded can postpone the escalation to multiple daily insulin injections in people with poorly controlled T2D.
Methods: This retrospective real-world study analyzed data from 309 adults with T2D in primary care who used a 10 or 14-day CGM (2020-2024).