title: Physicians' perceptions of a national consensus guideline on insulin therapy: Data from the IMPACT study.
abstract: BACKGROUND
  The effectiveness and impact of the Indian insulin guideline in clinical practice was evaluated by the Improving Management Practices and Clinical Outcomes in Type 2 Diabetes (IMPACT) Study. The study also evaluated the participating physicians' perceptions on the use of IIG versus RCP for management of diabetes.
  
  
  METHODS
  This 26 week multicenter, open label, randomized, prospective study aimed to evaluate effectiveness of Indian insulin guideline (IIG) versus routine clinical practice (RCP) in patients with type 2 diabetes (T2D).
  
  
  RESULTS
  Out of 426 physicians who completed the physicians' perception questionnaire, 189 (44.4%) felt that it was "easy" to initiate insulin in their patients using IIG. Cost of therapy (52.3%), followed by poor adherence (40.3%), and lack of motivation among physicians (40.4%) were the most important reasons cited for delay in initiation of insulin therapy. Two hundred and thirty three (54.7%) physicians felt that insulin titration was made "easy" in their patients using IIG, while 104 (24.4%) had a neutral approach. A total of 222 physicians (52.1%) felt it was "convenient" applying IIG in their practice, and 239 (67.8%) physicians felt "satisfied" with using IIG for achieving the targeted HbA1c <7%. One hundred and seventy seven (41.5%) physicians felt that there was scope for improving the IIG further by simplifying and revising the titration charts [117 (27.5%)].
  
  
  CONCLUSIONS
  Primary care physicians in India have perceived the IIG to be easy algorithm to initiate and titrate insulin therapy. These results will encourage the use and facilitate future revision of the guideline.
authors.affiliation: Bharti Hospital and B.R.I.D.E., Karnal, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kalra
authors.forename: C R A
authors.initials: CR
authors.lastname: Moses
authors.forename: V
authors.initials: V
authors.lastname: Seshiah
authors.forename: B K
authors.initials: BK
authors.lastname: Sahay
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: A J
authors.initials: AJ
authors.lastname: Asirvatham
authors.forename: V
authors.initials: V
authors.lastname: Balaji
authors.forename: A K
authors.initials: AK
authors.lastname: Das
authors.forename: S
authors.initials: S
authors.lastname: Akhtar
authors.forename: R
authors.initials: R
authors.lastname: Shetty
keywords: IMPACT; Insulin therapy; national consensus guidelines
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