Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective
The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and its complications are highly contributing to mortality. Compared to oral hypoglycemic agents, reduction in HbA1c is maximum with insulin therapy. Evidence suggests the potential benefits of achieving normoglycemia with ea...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | Endocrine and Metabolic Science |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666396121000261 |
| _version_ | 1818923117537394688 |
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| author | Viswanathan Mohan Jagat J Mukherjee Ashok K Das Krishna Seshadri Arundhati Dasgupta |
| author_facet | Viswanathan Mohan Jagat J Mukherjee Ashok K Das Krishna Seshadri Arundhati Dasgupta |
| author_sort | Viswanathan Mohan |
| collection | DOAJ |
| description | The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and its complications are highly contributing to mortality. Compared to oral hypoglycemic agents, reduction in HbA1c is maximum with insulin therapy. Evidence suggests the potential benefits of achieving normoglycemia with early intensive insulin therapy. Despite the high levels of uncontrolled T2DM in Indian patients, the use of insulin remains suboptimal. Initiation of insulin therapy in patients with T2DM is often inappropriately delayed due to physician's barriers. These include physicians’ inadequacy of skill and time required for insulin therapy, perceived complications of insulin therapy and perceived lack of treatment benefit. These barriers can be overcome by physician education and training, using effective patient education methods and tools, and bridging gaps to improve adherence by the patients. Pharmaceutical industry, government health authorities, medical institutions, healthcare professionals and patients can help to overcome the clinical inertia for the initiation and titration of insulin in patients with type 2 diabetes. |
| first_indexed | 2024-12-20T02:04:20Z |
| format | Article |
| id | doaj.art-276abf688fb745bbbb7851fc2bc9d59d |
| institution | Directory Open Access Journal |
| issn | 2666-3961 |
| language | English |
| last_indexed | 2024-12-20T02:04:20Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Endocrine and Metabolic Science |
| spelling | doaj.art-276abf688fb745bbbb7851fc2bc9d59d2022-12-21T19:57:14ZengElsevierEndocrine and Metabolic Science2666-39612021-09-014100103Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspectiveViswanathan Mohan0Jagat J Mukherjee1Ashok K Das2Krishna Seshadri3Arundhati Dasgupta4M.D., FRCP (London, Edinburgh, Glasgow, Ireland), Chairman & Chief Diabetologist, Dr. Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Conran Smith Road, Gopalapuram, Chennai 600 086, India; Corresponding author.MBBS, MD (Medicine), DNB (Medicine), MRCP, FAMS, FRCP, Senior Consultant, Div. of Diabetes & Endocrinology, Dept of Medicine, Apollo Gleneagles Hospital, 58 Canal Circular Road, KolkataMBBS, MD, PhD, DNB, FAMS, FICP, FACP, FRCP, Professor and Head of Medicine, JIPMER, PuducherrySenior Consultant, Chennai Diabetes and Endocrine Center, Chennai, Tamil Nadu, IndiaMBBS, MD, DM (Endo), Consultant Endocrinologist, Rudraksh Superspeciality Care, SiliguriThe prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and its complications are highly contributing to mortality. Compared to oral hypoglycemic agents, reduction in HbA1c is maximum with insulin therapy. Evidence suggests the potential benefits of achieving normoglycemia with early intensive insulin therapy. Despite the high levels of uncontrolled T2DM in Indian patients, the use of insulin remains suboptimal. Initiation of insulin therapy in patients with T2DM is often inappropriately delayed due to physician's barriers. These include physicians’ inadequacy of skill and time required for insulin therapy, perceived complications of insulin therapy and perceived lack of treatment benefit. These barriers can be overcome by physician education and training, using effective patient education methods and tools, and bridging gaps to improve adherence by the patients. Pharmaceutical industry, government health authorities, medical institutions, healthcare professionals and patients can help to overcome the clinical inertia for the initiation and titration of insulin in patients with type 2 diabetes.http://www.sciencedirect.com/science/article/pii/S2666396121000261 |
| spellingShingle | Viswanathan Mohan Jagat J Mukherjee Ashok K Das Krishna Seshadri Arundhati Dasgupta Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective Endocrine and Metabolic Science |
| title | Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective |
| title_full | Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective |
| title_fullStr | Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective |
| title_full_unstemmed | Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective |
| title_short | Initiation and intensification of insulin therapy in type 2 diabetes mellitus: Physician barriers and solutions – An Indian perspective |
| title_sort | initiation and intensification of insulin therapy in type 2 diabetes mellitus physician barriers and solutions an indian perspective |
| url | http://www.sciencedirect.com/science/article/pii/S2666396121000261 |
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