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04-11-2010 | Diabetes | Article

Predictors of switching to insulin in Types 2 diabetes clarified



MedWire News: Younger age at diagnosis, female gender, and high body mass index (BMI) and glycated hemoglobin (HbA1c) at initial clinic visit predict switching to insulin therapy in patients with Type 2 diabetes, say researchers.

Mohsen Janghorban and Masoud Amini from Isfahan University of Medical Sciences in Iran followed up 6896 non-insulin treated patients with Type 2 diabetes for a mean period of 9.3 years for incidence of progression to insulin therapy. At baseline, the participants were aged 51.2 years and had a mean diabetes duration of 5.8 years.

Over a total of 64,540 patient-years of follow-up, 1599 (23.2%) patients switched from diet and exercise (24.4%) or oral antidiabetes (75.6%) medication to insulin therapy, a rate of 2.5 per 100 patient years.

The researchers found that each additional year of age was associated with a significant 3% reduction in risk for switching to insulin, whereas each additional unit of BMI (kg/m2) at baseline significantly increased the risk for switching by 2%.

Each additional follow-up visit over the study period decreased the risk for switching by a significant 3%, while each 1% increase in HbA1c at baseline was linked with a significant 8% increase in risk for switching.

Finally, female gender increased the risk for switching to insulin by a significant 20%.

Writing in the journal Diabetes Research and Clinical Practice, the team concludes: "The findings of this study illustrate for the first time the switching rates and its predictors to insulin from a non-insulin regimen in patients with Type 2 diabetes in Iran."

They suggest: "These findings may be taken into account in future treatment decisions."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert