{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:18:07Z","timestamp":1791897487303,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T00:00:00Z","timestamp":1476748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2017,1]]},"abstract":"\n Background<\/jats:title>\n Real world outcomes of addition or switch to insulin therapy in type 2 diabetes (T2DM) patients on glucagon\u2010like paptide\u20101 receptor agonist (GLP\u20101RA) with inadequately controlled hyperglycaemia, are not known.<\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n \n Patients with\n T2DM<\/jats:styled-content>\n (n = 66 583) with a minimum of 6 months of\n GLP\u20101RA<\/jats:styled-content>\n treatment and without previous insulin treatment were selected. Those who added insulin (n = 39 599) or switched to insulin after\n GLP\u20101RA<\/jats:styled-content>\n cessation (n = 4706) were identified. Adjusted changes in glycated haemoglobin (\n HbA1c<\/jats:styled-content>\n ), weight, systolic blood pressure (\n SBP<\/jats:styled-content>\n ), and\n LDL<\/jats:styled-content>\n cholesterol were estimated over 24 months follow\u2010up.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among those who continued with\n GLP\u20101RA<\/jats:styled-content>\n treatment without adding or switching to insulin, the highest adjusted mean\n HbA1c<\/jats:styled-content>\n change was achieved within 6 months, with no further glycaemic benefits observed during 24 months of follow\u2010up. Addition of insulin within 6 months of\n GLP\u20101RA<\/jats:styled-content>\n initiation was associated with 18% higher odds of achieving\n HbA1c<\/jats:styled-content>\n <7% at 24 months, compared with adding insulin later. At 24 months, those who added insulin reduced\n HbA1c<\/jats:styled-content>\n significantly by 0.55%, while no glycaemic benefit was observed in those who switched to insulin. Irrespective of intensification with insulin, weight,\n SBP<\/jats:styled-content>\n and\n LDL<\/jats:styled-content>\n cholesterol were significantly reduced by 3 kg, 3 mm Hg, and 0.2 mmol\/L, respectively, over 24 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Significant delay in intensification of treatment by addition of insulin is observed in patients with\n T2DM<\/jats:styled-content>\n inadequately controlled with\n GLP\u20101RA<\/jats:styled-content>\n . Earlier addition of insulin is associated with better glycaemic control, while switching to insulin is not clinically beneficial during 2 years of treatment. Non\u2010responding patients on\n GLP\u20101RA<\/jats:styled-content>\n would benefit from adding insulin therapy, rather than switching to insulin.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.12790","type":"journal-article","created":{"date-parts":[[2016,9,15]],"date-time":"2016-09-15T05:26:14Z","timestamp":1473917174000},"page":"108-117","source":"Crossref","is-referenced-by-count":39,"title":["Addition of or switch to insulin therapy in people treated with glucagon\u2010like peptide\u20101 receptor agonists: A real\u2010world study in 66 583 patients"],"prefix":"10.1111","volume":"19","author":[{"given":"Olga","family":"Montvida","sequence":"first","affiliation":[{"name":"Clinical Trials and Biostatistics Unit QIMR Berghofer Medical Research Institute Brisbane Australia"},{"name":"School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Faculty of Health Queensland University of Technology Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerenaftali","family":"Klein","sequence":"additional","affiliation":[{"name":"Clinical Trials and Biostatistics Unit QIMR Berghofer Medical Research Institute Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Warwick Medical School University of Warwick, and University Hospitals Coventry and Warwickshire Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Diabetes Research Centre, Leicester Diabetes Centre University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjoy K.","family":"Paul","sequence":"additional","affiliation":[{"name":"Clinical Trials and Biostatistics Unit QIMR Berghofer Medical Research Institute Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1470-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70219-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000230"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-S011"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0178-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006985"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62299-4"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.2012.638282"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12175"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dcS13-2036"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2014.10.2824"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-3010"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61335-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12285"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-014-0084-9"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-015-0385-5"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-015-0245-x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"crossref","unstructured":"RyderB ThongK. 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