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Treatment lags in diabetes

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Treatment lags in diabetes

Many patients are not on the most appropriate therapy, according to a retrospective review of 20,300 people in the UK with newly diagnosed type 2 diabetes.

The study, sponsored by Janssen, found that patients moved from diet and exercise to monotherapy, on average, 0.9 years after diagnosis, to dual therapy after 1.9 years, and to triple therapy after 3.1 years. However 63 per cent of patients who received insulin began insulin treatment directly after diet and exercise alone or monotherapy, on average, 1.6 years after diagnosis.

Mean HbA1c was 8.0 per cent in those taking monotherapy, 8.9 per cent with dual therapy, 9.3 per cent with triple therapy and 9.4 per cent among insulin users. Furthermore, 66 per cent of untreated patients, 78 per cent of those on monotherapy and 66 per cent of people taking dual therapy showed HbA1c levels above the NICE threshold.

Treatment with non-insulin drugs “tended to be delayed beyond the [NICE] recommended threshold values for HbA1c in the majority of cases,” the authors observed, speculating that inadequate titration and using higher HbA1c thresholds because of “the needs and characteristics of the patient population” might be the reason for this.

Data presented at the Diabetes UK Professional Conference held in London in March

Treatment in diabetes sub-optimal?

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