{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:12:19Z","timestamp":1762506739041},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,14]],"date-time":"2016-02-14T00:00:00Z","timestamp":1455408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the patient characteristics associated with early initiation of insulin after a diagnosis of Type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed cross\u2010sectional data from the 2012 Canadian Community Health Survey conducted by Statistics Canada. Multivariable logistic regression was used to explore the association between patient sociodemographic and health status characteristics and initiating insulin within 1 year of a diagnosis of Type 2 diabetes (early insulin use).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Weighted estimates for the Canadian population showed that 32% of patients with Type 2 diabetes initiated insulin within 1 year of their diagnosis. Of the insulin initiators, 52% were female and 68% were aged \u226560 years. Factors strongly associated with early initiation of insulin were age (60\u201369 years: adjusted odds ratio 1.89, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.84\u20131.94; \u2265 70 years, odds ratio 2.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.01\u20132.15, both vs 40\u201349 years); smoking (smoker vs never: odds ratio 2.39, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.32\u20132.46); geography (Western Canada: odds ratio 2.75, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.69\u20132.81; Quebec: odds ratio 2.20, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.13\u20132.27, both vs Ontario); mental health (poor vs excellent: odds ratio 1.98, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.92\u20132.04); <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> (overweight vs normal\/underweight: odds ratio 1.63, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.58\u20131.67); oral antidiabetic medication use (yes vs no: odds ratio 0.66, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.65\u20130.68); and alcohol use (regular vs non\u2010drinker: odds ratio 0.66, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.65\u20130.68).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One\u2010third of the study population with Type 2 diabetes initiated insulin within their first year of diagnosis. Age, smoking status, geographical location, mental health, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, education, oral antidiabetic medication use, employment, physical activity, language, doctor visits and alcohol consumption were associated with timing of insulin initiation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13082","type":"journal-article","created":{"date-parts":[[2016,1,23]],"date-time":"2016-01-23T14:28:40Z","timestamp":1453559320000},"page":"229-234","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors associated with early insulin initiation in Type 2 diabetes: a Canadian cross\u2010sectional study"],"prefix":"10.1111","volume":"34","author":[{"given":"W.","family":"Abu\u2010Ashour","sequence":"first","affiliation":[{"name":"School of Pharmacy Memorial University of Newfoundland St. John's NL Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Chibrikova","sequence":"additional","affiliation":[{"name":"School of Pharmacy Memorial University of Newfoundland St. John's NL Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. K.","family":"Midodzi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Memorial University of Newfoundland St. John's NL Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. K.","family":"Twells","sequence":"additional","affiliation":[{"name":"School of Pharmacy Memorial University of Newfoundland St. John's NL Canada"},{"name":"Faculty of Medicine Memorial University of Newfoundland St. John's NL Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.\u2010M.","family":"Gamble","sequence":"additional","affiliation":[{"name":"School of Pharmacy Memorial University of Newfoundland St. John's NL Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.2337\/diab.44.11.1249","article-title":"16. Overview of 6 years therapy of type II diabetes: a progressive disease. UK prospective diabetes study group","volume":"44","author":"UK Prospective Diabetes Study","year":"1995","journal-title":"Diabetes"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0413"},{"key":"e_1_2_9_4_1","first-page":"S61","article-title":"Clinical Practice Guidelines: Pharmacologic Management of Type 2 Diabetes Canadian Diabetes Association Clinical Practice Guidelines Expert Committee Can J","volume":"37","author":"Harper W","year":"2013","journal-title":"Diabetes"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2004.11.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-S321"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.1.7157"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12260"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.6316"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S51299"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-2170"},{"key":"e_1_2_9_12_1","first-page":"1","volume-title":"Predicting health behaviours","author":"Conner M","year":"2005"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02628.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12128"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70137-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003384"},{"key":"e_1_2_9_17_1","volume-title":"The Canadian Rx Atlas","author":"Morgan S","year":"2013"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6979.555"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.17.2.115"},{"key":"e_1_2_9_20_1","unstructured":"Health Canada.Diabetes in Canada: national statistics and opportunities for improved surveillance prevention and control.Ottwa: Minister of public works and government services; Report No:H49\u2010121\/1999."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.12.3193"},{"key":"e_1_2_9_22_1","unstructured":"Statistics Canada. Canadian Community Health Survey (CCHS)Annual Component. User guide 2012 and 2011\u20102012 Microdata Files. Available atwww.statcan.gc.caLast accessed 14 November 2015."}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13082","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13082","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T07:39:36Z","timestamp":1695973176000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,14]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1111\/dme.13082"],"URL":"https:\/\/doi.org\/10.1111\/dme.13082","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,14]]},"assertion":[{"value":"2016-01-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}