Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey
ObjectiveThe inertia of insulin initiation is a barrier to achieving glycemic control when oral antidiabetic drugs fail to control glucose during the treatment of type 2 diabetes (T2D). Insulin initiation is usually based on glycated hemoglobin A1c (A1C). To investigate whether there is another inde...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.998210/full |
| _version_ | 1798015808135233536 |
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| author | Yanli Li Yan Wu Yi Shu Shu Li Jianhao Pei Hong Chen Shiping Liu Guangda Xiang Wenbo Wang Pengfei Shan Heng Su Xiaoyan Wu Dewen Yan Wangen Li |
| author_facet | Yanli Li Yan Wu Yi Shu Shu Li Jianhao Pei Hong Chen Shiping Liu Guangda Xiang Wenbo Wang Pengfei Shan Heng Su Xiaoyan Wu Dewen Yan Wangen Li |
| author_sort | Yanli Li |
| collection | DOAJ |
| description | ObjectiveThe inertia of insulin initiation is a barrier to achieving glycemic control when oral antidiabetic drugs fail to control glucose during the treatment of type 2 diabetes (T2D). Insulin initiation is usually based on glycated hemoglobin A1c (A1C). To investigate whether there is another index for insulin initiation besides A1C, we conducted a cross-sectional survey in the real world.MethodsWe conducted a multicenter cross-section survey with a total of 1034 T2D patients. All patients, at the time of the survey, decided to initiate insulin therapy due to failure of controlling glucose using only oral antidiabetic drugs. We analyzed the differences of blood glucose between patients who were tested for A1C and those who were not.Results666 (64.4%) patients were tested A1C and 368 (35.6%) were not. Neither fasting blood glucose (FBG) (12.0 ± 2.9 vs 12.3 ± 2.9 mmol/L, t = 1.494, P = 0.135) nor postprandial blood glucose (PBG) (18.4 ± 4.8 vs 17.9 ± 4.8 mmol/L, t = 1.315, P = 0.189) were significantly different between patients with and without A1C.ConclusionOur results demonstrated that initiating insulin based on FBG or PBG is a common clinical practice, at least in China; moreover, since it is easier to obtain than A1C, it can be a simple and effective way to overcome clinical inertia for initiating insulin. |
| first_indexed | 2024-04-11T15:39:36Z |
| format | Article |
| id | doaj.art-ba10e068ddff4aaa94a0fe684f02d603 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-11T15:39:36Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-ba10e068ddff4aaa94a0fe684f02d6032022-12-22T04:15:51ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-11-011310.3389/fendo.2022.998210998210Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world surveyYanli Li0Yan Wu1Yi Shu2Shu Li3Jianhao Pei4Hong Chen5Shiping Liu6Guangda Xiang7Wenbo Wang8Pengfei Shan9Heng Su10Xiaoyan Wu11Dewen Yan12Wangen Li13Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Endocrinology, Shenzhen People’s Hospital, Shenzhen, ChinaDepartment of Endocrinology, The Sixth Affiliated Hospital of South China University of Technology, Foshan, ChinaDepartment of Endocrinology, Huizhou Municipal Central Hospital, Huizhou, ChinaDepartment of Endocrinology, Guangdong Provincial People’s Hospital, Guangzhou, ChinaDepartment of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, ChinaDepartment of Endocrinology, General Hospital of Central Theater Command, Wuhan, ChinaDepartment of Endocrinology, Peking University Shougang Hospital, Beijing, China0Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China1Department of Endocrinology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China2Department of Endocrinology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China3Department of Endocrinology, The First Affiliated Hospital of Shenzhen University, Shenzhen, ChinaDepartment of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaObjectiveThe inertia of insulin initiation is a barrier to achieving glycemic control when oral antidiabetic drugs fail to control glucose during the treatment of type 2 diabetes (T2D). Insulin initiation is usually based on glycated hemoglobin A1c (A1C). To investigate whether there is another index for insulin initiation besides A1C, we conducted a cross-sectional survey in the real world.MethodsWe conducted a multicenter cross-section survey with a total of 1034 T2D patients. All patients, at the time of the survey, decided to initiate insulin therapy due to failure of controlling glucose using only oral antidiabetic drugs. We analyzed the differences of blood glucose between patients who were tested for A1C and those who were not.Results666 (64.4%) patients were tested A1C and 368 (35.6%) were not. Neither fasting blood glucose (FBG) (12.0 ± 2.9 vs 12.3 ± 2.9 mmol/L, t = 1.494, P = 0.135) nor postprandial blood glucose (PBG) (18.4 ± 4.8 vs 17.9 ± 4.8 mmol/L, t = 1.315, P = 0.189) were significantly different between patients with and without A1C.ConclusionOur results demonstrated that initiating insulin based on FBG or PBG is a common clinical practice, at least in China; moreover, since it is easier to obtain than A1C, it can be a simple and effective way to overcome clinical inertia for initiating insulin.https://www.frontiersin.org/articles/10.3389/fendo.2022.998210/fullinitiating insulinglycated hemoglobin A1cblood glucosetype 2 diabetesinertia |
| spellingShingle | Yanli Li Yan Wu Yi Shu Shu Li Jianhao Pei Hong Chen Shiping Liu Guangda Xiang Wenbo Wang Pengfei Shan Heng Su Xiaoyan Wu Dewen Yan Wangen Li Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey Frontiers in Endocrinology initiating insulin glycated hemoglobin A1c blood glucose type 2 diabetes inertia |
| title | Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey |
| title_full | Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey |
| title_fullStr | Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey |
| title_full_unstemmed | Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey |
| title_short | Blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin A1c after oral antidiabetic medications failure for glycemic control: A real–world survey |
| title_sort | blood glucose may be another index to initiate insulin treatment besides glycated hemoglobin a1c after oral antidiabetic medications failure for glycemic control a real world survey |
| topic | initiating insulin glycated hemoglobin A1c blood glucose type 2 diabetes inertia |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.998210/full |
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