Effect of delay in treatment intensification in people with type 2 diabetes and suboptimal glycaemia after basal insulin initiation: A real‐world observational study
Main finding · Macrovascular complications, age <65 yearsResult — go to the resultAdjusted hazard ratio 1.56 95% CI 1.08–2.26Authors' conclusion
Those who had late intensification were at an increased risk of cardiovascular death if they were ≥65 years and an increased risk of macrovascular complications if they were <65 years. These findings highlight the critical need for earlier intensification of treatment and adopting personalized treatment strategies to improve patient outcomes.
Study context
- Population
- People with T2D initiated on basal insulin (BI); suboptimal glycaemia defined as HbA1c ≥7% (≥53 mmol/mol) within 12 months of BI initiationsuboptimal glycaemia
- Participants
- 13,916 people
- Exposure
- Late (≥5 years) vs early (within 5 years) treatment intensification after BI initiation, each vs optimal glycaemia
- Outcome
- Micro- and macrovascular complications (age-stratified)
Methodological detailsreal-world, age-stratified
- Real-world
- Age-stratified
Main finding
Macrovascular complications, age <65 years
Adjusted hazard ratio
1.56
95% CI 1.08–2.26
Late intensificationvs Optimal glycaemia
aHR 1.56 (95% CI 1.08–2.26)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Cardiovascular-related death, age ≥65 yearsLate intensification vs Optimal glycaemia | 1.62 (CI 1.03–2.54) |
| Microvascular complications, age ≥65 yearsLate intensification vs Optimal glycaemia | 0.26 (CI 0.08–0.83) |
No treatment intensification among those with suboptimal glycaemia
- Did not receive any treatment intensification
- 52.5% (n = 7304)
Original publication
Effect of delay in treatment intensification in people with type 2 diabetes and suboptimal glycaemia after basal insulin initiation: A real‐world observational study. Diabetes Obes Metab. Published 19 October 2023. doi:10.
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