Open questions on basal insulin therapy in T2D: a Delphi consensus
Rattachement africain : it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
AIMS: The revolution in the therapeutic approach to type 2 diabetes (T2D) requires a rethinking of the positioning of basal insulin (BI) therapy. Given the considerable number of open questions, a group of experts was convened with the aim of providing, through a Delphi consensus method, practical guidance for doctors. METHODS: A group of 6 experts developed a series of 29 statements on: the role of metabolic control in light of the most recent guidelines; BI intensification strategies: (1) add-on versus switch; (2) inertia in starting and titrating; (3) free versus fixed ratio combination; basal-bolus intensification and de-intensification strategies; second generation analogues of BI (2BI). A panel of 31 diabetologists, by accessing a dedicated website, assigned each statement a relevance score on a 9-point scale. The RAND/UCLA Appropriateness Method was adopted to assess the existence of disagreement among participants. RESULTS: Panelists showed agreement for all 29 statements, of which 26 were considered relevant, one was considered not relevant and two were of uncertain relevance. Panelists agreed that the availability of new classes of drugs often allows the postponement of BI and the simplification of therapy. It remains essential to promptly initiate and titrate BI when required. BI should always, unless contraindicated, be started in addition to, and not as a replacement, for ongoing treatments with cardiorenal benefits. 2BIs should be preferred for their pharmacological profile, greater ease of self-titration and flexibility of administration. CONCLUSION: In a continuously evolving scenario, BI therapy still represents an important option in the management of T2D patients.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Open questions on basal insulin therapy in T2D: a Delphi consensus
- Date Crossref
- 20/05/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
University of Trieste Department of Medical Surgical and Health Sciences pays non établi dans la noticeUniversité ou école supérieure
-
Università Cattolica del Sacro Cuore Center for Endocrine and Metabolic Diseases pays non établi dans la noticeUniversité ou école supérieure
-
Sapienza University of Rome Department of Experimental Medicine pays non établi dans la noticeUniversité ou école supérieure
-
University of Campania "Luigi Vanvitelli" pays non établi dans la noticeUniversité ou école supérieure
-
University of Florence Diabetology pays non établi dans la noticeUniversité ou école supérieure
-
Center for Outcomes Research and Clinical Epidemiology pays non établi dans la noticeOrganisation à but non lucratif
-
University of Messina Department of Clinical and Experimental Medicine pays non établi dans la noticeUniversité ou école supérieure
-
Department of Advanced Medical and Surgical Sciences pays non établi dans la noticeInstitution
Department of Medical Surgical and Health Sciences — University of Trieste, Center for Endocrine and Metabolic Diseases — Università Cattolica del Sacro Cuore et Department of Experimental Medicine — Sapienza University of Rome, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.