Trends of insulin use among US adults with type 2 diabetes: the Behavioral Risk Factor Surveillance System, 1995-2007.
OBJECTIVE
People with type 2 diabetes may need insulin therapy to compensate for their underlying pathogenic abnormalities and to improve glycemic control. We examined trends of insulin use among US adults aged ≥40 years with type 2 diabetes.


METHODS
We analyzed data from the Behavioral Risk Factor Surveillance System collected annually during 1995-2007. Insulin use was assessed by self-report. Log-linear regression analyses with a robust error variance estimator were performed to estimate the prevalence, prevalence ratios, and their 95% confidence intervals.


RESULTS
The overall crude and age-standardized proportion of insulin use decreased from 35% and 36% in 1995 to 23% and 22% in 2007, respectively. After adjustments for age, sex, race/ethnicity, education attainment, body mass index, and diabetes duration, the overall prevalence decreased from 33% to 22% (P<.0001 for linear trend). The decreasing rates were similar across sex (P=.23 for interaction between sex and survey year) and race/ethnicity (P=.35 for interaction between race/ethnicity and survey year).


CONCLUSIONS
The proportion of insulin use decreased from 1995 to 2007 among US adults aged ≥40 years. Continuing efforts may be needed to properly identify those who may need to initiate and maintain insulin therapy among patients with type 2 diabetes as medically indicated.
Division of Behavioral Surveillance, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cli@cdc.gov
Chaoyang
C
Li
Earl S
ES
Ford
Guixiang
G
Zhao
James
J
Tsai
Lina S
LS
Balluz
Wayne H
WH
Giles
D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report
D007004:Hypoglycemic Agents; D007328:Insulin