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We evaluated clinical characteristics of T2D subjects undergoing the first insulin prescription during a 15-year-observation period in the large cohort of the AMD Annals Initiative in Italy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data on clinical and laboratory variables, complications and concomitant therapies and the effects on glucose control after 12\u00a0months were evaluated in T2D patients starting basal insulin as add-on to oral\/non-insulin injectable agents, and in those starting fast-acting in add-on to basal insulin therapy in three 5-year periods (2005\u20132019).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We evaluated data from 171.688 T2D subjects who intensified therapy with basal insulin and 137.225 T2D patients who started fast-acting insulin. Overall, intensification with insulin occurred progressively earlier over time in subjects with shorter disease duration. Moreover, the percentage of subjects with HbA1c levels\u2009&gt;\u20098% at the time of basal insulin initiation progressively decreased. The same trend was observed for fast-acting formulations. Clinical characteristics of subjects starting insulin did not change in the three study-periods, although all major risk factors improved overtime. After 12\u00a0months from the starting of basal or fast-acting insulin therapy, mean HbA1c levels decreased in all the three investigated time-periods, although mean HbA1c levels remained above the recommended target.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this large cohort of T2D subjects, a progressively earlier start of insulin treatment was observed during a long observation period, suggesting a more proactive prescriptive approach. However, after 12\u00a0months from insulin prescription, in many patients, HbA1c levels were still out-of-target.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40618-024-02306-5","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T13:03:22Z","timestamp":1709643802000},"page":"2087-2096","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Temporal trends in the starting of insulin therapy in type 2 diabetes in Italy: data from the AMD Annals initiative"],"prefix":"10.1007","volume":"47","author":[{"given":"A.","family":"Giandalia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Nicolucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Modugno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Lucisano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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Ann Med 53(1):998\u20131009. https:\/\/doi.org\/10.1080\/07853890.2021.1925148","journal-title":"Ann Med"}],"container-title":["Journal of Endocrinological Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40618-024-02306-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40618-024-02306-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40618-024-02306-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T02:08:08Z","timestamp":1721786888000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40618-024-02306-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["2306"],"URL":"https:\/\/doi.org\/10.1007\/s40618-024-02306-5","relation":{},"ISSN":["1720-8386"],"issn-type":[{"value":"1720-8386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]},"assertion":[{"value":"17 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Data for this analysis comes from the database of the Annals Initiative of the Italian Association of Medical Diabetologists (AMD, Associazione Medici Diabetologi). The database includes clinical information on all patients with diabetes receiving care at 295 diabetes centers in Italy. Patients and centers are identified by numeric codes, and analysis is centralized. Participating centers share a software developed to extract information from electronic medical records. Data are centrally collected and analyzed anonymously. Due to the methodology of data extraction, the center, patients and all data are anonymous and there is no possibility of tracing the patient's name. Local ethics committees of each participating center approved the study protocol. The project is conducted without allocation of extra resources or financial incentives.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The AMD Annals Initiative database is anonymous by study-design and the analysis is retrospective. Given the nature of the study, based on the Italian regulations, the signature of the informed consent was not requested.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}