Predictors of switching to insulin from non-insulin therapy in patients with type 2 diabetes mellitus.
OBJECTIVE
To estimate the switching rate and to identify factors that predict switch from non-insulin to insulin therapy in patients with type 2 diabetes using routinely collected data from a clinical information system at Isfahan Endocrine and Metabolism Research Centre, Iran.


METHODS
During the mean (SD) follow-up period of 9.3 (3.4) years, 6896 non-insulin-treated patients with type 2 diabetes at baseline have been examined to determine predictors of switches to insulin therapy. Their treatment at the last clinic visit was compared with the initial visit treatment. The mean (SD) age of participants was 51.2 (10.3) years with a mean (SD) duration of diabetes of 5.8 (5.9) years at initial registration.


RESULTS
The switch to insulin from non-insulin therapy was 2.5 (95% confidence interval 2.4, 2.6) (2.2 men and 2.7 women) per 100 patient-years based on 64,540 patient-years of follow-up. Using a Cox's proportional hazards model, younger age at diagnosis, female gender, higher BMI and HbA(1c) were significant predictors of switch to insulin treatment.


CONCLUSIONS
These are the first estimate of switch to insulin from non-insulin therapy in Iran. Younger age at diagnosis, female gender, higher BMI and HbA(1c) at registration were identified as predictors of switching to insulin.
Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. janghorbani@yahoo.com
Mohsen
M
Janghorbani
Mohsen
M
Janghorban
Masoud
M
Amini
D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D007328:Insulin