Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data

Background: Poor glycemic control in patients with type 2 diabetes is commonly recorded worldwide; Latin America (LA) is not an exception. Barriers to intensifying insulin therapy and which barriers are most likely to negatively impact outcomes are not completely known. The objective was to identify...

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Autores principales: Linetzky, Bruno, Curtis, Brad, Frechtel, Gustavo, Montenegro, Renan, Escalante Pulido, Miguel, Stempa, Oded, Lana, Janaina M., Gagliardino, Juan José
Formato: Articulo
Lenguaje:Inglés
Publicado: 2016
Materias:
Ciencias Médicas
Diabetes education
Diabetes knowledge
Diabetes self-care management
Insulin treatment
Latin America
Observational study
Psychological impact
Quality of care
Type 2 diabetes
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/86214
Aporte de:
SEDICI (UNLP) de Universidad Nacional de La Plata
id I19-R120-10915-86214
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
Diabetes education
Diabetes knowledge
Diabetes self-care management
Insulin treatment
Latin America
Observational study
Psychological impact
Quality of care
Type 2 diabetes
spellingShingle Ciencias Médicas
Diabetes education
Diabetes knowledge
Diabetes self-care management
Insulin treatment
Latin America
Observational study
Psychological impact
Quality of care
Type 2 diabetes
Linetzky, Bruno
Curtis, Brad
Frechtel, Gustavo
Montenegro, Renan
Escalante Pulido, Miguel
Stempa, Oded
Lana, Janaina M.
Gagliardino, Juan José
Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
topic_facet Ciencias Médicas
Diabetes education
Diabetes knowledge
Diabetes self-care management
Insulin treatment
Latin America
Observational study
Psychological impact
Quality of care
Type 2 diabetes
description Background: Poor glycemic control in patients with type 2 diabetes is commonly recorded worldwide; Latin America (LA) is not an exception. Barriers to intensifying insulin therapy and which barriers are most likely to negatively impact outcomes are not completely known. The objective was to identify barriers to insulin progression in individuals with type 2 diabetes mellitus (T2DM) in LA countries (Mexico, Brazil, and Argentina). Methods: MOSAIc is a multinational, non-interventional, prospective, observational study aiming to identify the patient-, physician-, and healthcare-based factors affecting insulin intensification. Eligible patients were ≥18 years, had T2DM, and were treated with insulin for ≥3 months with/without oral antidiabetic drugs (OADs). Demographic, clinical, and psychosocial data were collected at baseline and regular intervals during the 24-month follow-up period. This paper however, focuses on baseline data analysis. The association between glycated hemoglobin (HbA1c) and selected covariates was assessed. Results: A trend toward a higher level of HbA1c was observed in the LA versus non-LA population (8.40 ± 2.79 versus 8.18 ± 2.28; p ≤ 0.069). Significant differences were observed in clinical parameters, treatment patterns, and patient-reported outcomes in LA compared with the rest of the cohorts and between Mexico, Brazil, and Argentina. Higher number of insulin injections and lower number of OADs were used, whereas a lower level of knowledge and a higher level of diabetes-related distress were reported in LA. Covariates associated with HbA1c levels included age (-0.0129; p < 0.0001), number of OADs (0.0835; p = 0.0264), higher education level (-0.2261; p = 0.0101), healthy diet (-0.0555; p = 0.0083), self-monitoring blood glucose (-0.0512; p = 0.0033), hurried communication style in the process of care (0.1295; p = 0.0208), number of insulin injections (0.1616; p = 0.0088), adherence (-0.1939; p ≤ 0.0104), and not filling insulin prescription due to associated cost (0.2651; p = 0.0198). Conclusion: MOSAIc baseline data showed that insulin intensification in LA is not optimal and identified several conditions that significantly affect attaining appropriate HbA1c values. Tailored public health strategies, including education, should be developed to overcome such barriers.
format Articulo
Articulo
author Linetzky, Bruno
Curtis, Brad
Frechtel, Gustavo
Montenegro, Renan
Escalante Pulido, Miguel
Stempa, Oded
Lana, Janaina M.
Gagliardino, Juan José
author_facet Linetzky, Bruno
Curtis, Brad
Frechtel, Gustavo
Montenegro, Renan
Escalante Pulido, Miguel
Stempa, Oded
Lana, Janaina M.
Gagliardino, Juan José
author_sort Linetzky, Bruno
title Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
title_short Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
title_full Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
title_fullStr Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
title_full_unstemmed Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data
title_sort challenges associated with insulin therapy progression among patients with type 2 diabetes: latin american mosaic study baseline data
publishDate 2016
url http://sedici.unlp.edu.ar/handle/10915/86214
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