{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T09:11:29Z","timestamp":1778490689237,"version":"3.51.4"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T00:00:00Z","timestamp":1630281600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The aim of the study was to assess the initiation of insulin therapy in patients with type 2 diabetes using health claims data on prescription medicines. The study evaluated time to insulin initiation and prescribing patterns of other anti-diabetic medicines before and after insulin initiation. Five years after starting non-insulin antidiabetic therapy, 6.4 % of patients were prescribed insulin, which is substantially lower compared to other similar studies. Among all patients who initiated insulin therapy in 2013, 30 % did not continue any other antidiabetic therapy. However, this proportion was lowered to 20 % in 2018. Before insulin initiation in 2018, metformin was prescribed in only 67 % of patients and sulfonylureas in 78 % of patients. Moreover, metformin and sulfonylureas were discontinued after insulin initiation in 26 and 37 % of patients, resp. More attention should be paid to the continuation of oral anti-diabetics, particularly metformin, after insulin initiation.<\/jats:p>","DOI":"10.2478\/acph-2022-0011","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T17:44:28Z","timestamp":1630431868000},"page":"147-157","source":"Crossref","is-referenced-by-count":2,"title":["Initiation of insulin therapy in patients with type 2 diabetes: An observational study"],"prefix":"10.2478","volume":"72","author":[{"given":"Spela","family":"Zerovnik","sequence":"first","affiliation":[{"name":"University of Ljubljana , Faculty of Pharmacy Ljubljana , Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitja","family":"Kos","sequence":"additional","affiliation":[{"name":"University of Ljubljana , Faculty of Pharmacy Ljubljana , Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Locatelli","sequence":"additional","affiliation":[{"name":"University of Ljubljana , Faculty of Pharmacy Ljubljana , Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,8,30]]},"reference":[{"key":"2026051108211972878_j_acph-2022-0011_ref_001","doi-asserted-by":"crossref","unstructured":"1. M. J. Davies, D. A. D\u2019Alessio, J. Fradkin, W. N. Kernan, C. Mathieu, G. Mingrone, P. Rossing, A. Tsapas, D. J. Wexler and J. B. Buse, Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), Diabetes Care 41 (2018) 2669\u20132701; https:\/\/doi.org\/10.2337\/dci18-003310.2337\/dci18-0033624520830291106","DOI":"10.2337\/dci18-0033"},{"key":"2026051108211972878_j_acph-2022-0011_ref_002","unstructured":"2. Slovenian Endocrinology Association, Slovenian Guidelines on Type 2 Diabetes Management 2016 [in Slovene]; https:\/\/endodiab.si\/priporocila\/smernice-za-vodenje-sladkorne-bolezni\/; last access date November 30, 2020."},{"key":"2026051108211972878_j_acph-2022-0011_ref_003","doi-asserted-by":"crossref","unstructured":"3. P. Home, M. Riddle, W. T. Cefalu, C. J. Bailey, R. G. Bretzel, S. Del Prato, D. Leroith, G. Schernthaner, L. van Gaal and I. Raz, Insulin therapy in people with type 2 diabetes: opportunities and challenges? Diabetes Care 37 (2014) 1499\u20131508; https:\/\/doi.org\/10.2337\/dc13-274310.2337\/dc13-2743513188424855154","DOI":"10.2337\/dc13-2743"},{"key":"2026051108211972878_j_acph-2022-0011_ref_004","doi-asserted-by":"crossref","unstructured":"4. M. D. Campbell, D. Babic, U. Bolcina, L. Smir\u010di\u0107-Duvnjak, T. Tankova, A. Mitrakou, P. Kempler and A. Janez, High level of clinical inertia in insulin initiation in type 2 diabetes across Central and South-Eastern Europe: insights from SITIP study, Acta Diabetol. 56 (2019) 1045\u20131049; https:\/\/doi.org\/10.1007\/s00592-019-01346-110.1007\/s00592-019-01346-1667575330993528","DOI":"10.1007\/s00592-019-01346-1"},{"key":"2026051108211972878_j_acph-2022-0011_ref_005","doi-asserted-by":"crossref","unstructured":"5. G. Goodall, E. M. Sarpong, C. Hayes and W. J. Valentine, The consequences of delaying insulin initiation in UK type 2 diabetes patients failing oral hyperglycaemic agents: a modelling study, BMC Endocr. Disord. 9 (2009) Article ID 19 (9 pages); https:\/\/doi.org\/10.1186\/1472-6823-9-1910.1186\/1472-6823-9-19276191319804622","DOI":"10.1186\/1472-6823-9-19"},{"key":"2026051108211972878_j_acph-2022-0011_ref_006","unstructured":"6. T. Albreht, R. Pribakovi\u0107 Brinovec, D. Jo\u0161ar, M. Poldrugovac, T. Kostnapfel, M. Zaletel, D. Panteli and A. Maresso, Slovenia: Health system review, Health Syst. Trans. 18 (2016) (207 pages); https:\/\/www.euro.who.int\/_data\/assets\/pdf_file\/0018\/312147\/HiT-Slovenia_rev3.pdf; last access date February 15, 2021."},{"key":"2026051108211972878_j_acph-2022-0011_ref_007","doi-asserted-by":"crossref","unstructured":"7. E. Chiefari, B. Arcidiacono, D. Foti and A. Brunetti, Gestational diabetes mellitus: an updated overview, J. Endocrinol. Invest. 40 (2017) 899\u2013909; https:\/\/doi.org\/10.1007\/s40618-016-0607-510.1007\/s40618-016-0607-528283913","DOI":"10.1007\/s40618-016-0607-5"},{"key":"2026051108211972878_j_acph-2022-0011_ref_008","doi-asserted-by":"crossref","unstructured":"8. O. Montvida, J. Shaw, J. J. Atherton, F. Stringer and S. K. Paul, Long-term trends in antidiabetes drug usage in the U.S.: Real-world evidence in patients newly diagnosed with type 2 diabetes, Diabetes Care 41 (2018) 69\u201378; https:\/\/doi.org\/10.2337\/dc17-141410.2337\/dc17-141429109299","DOI":"10.2337\/dc17-1414"},{"key":"2026051108211972878_j_acph-2022-0011_ref_009","doi-asserted-by":"crossref","unstructured":"9. S. Wilkinson, I. Douglas, H. Stirnadel-Farrant, D. Fogarty, A. Pokrajac, L. Smeeth and L. Tomlinson, Changing use of antidiabetic drugs in the UK: trends in prescribing 2000-2017, BMJ Open 8 (2018) e022768; https:\/\/doi.org\/10.1136\/bmjopen-2018-02276810.1136\/bmjopen-2018-022768606740030056393","DOI":"10.1136\/bmjopen-2018-022768"},{"key":"2026051108211972878_j_acph-2022-0011_ref_010","doi-asserted-by":"crossref","unstructured":"10. M. Sharma, I. Nazareth and I. Petersen, Trends in incidence, prevalence and prescribing in type 2 diabetes mellitus between 2000 and 2013 in primary care: a retrospective cohort study, BMJ Open 6 (2016) e010210; https:\/\/doi.org\/10.1136\/bmjopen-2015-01021010.1136\/bmjopen-2015-010210473517626769791","DOI":"10.1136\/bmjopen-2015-010210"},{"key":"2026051108211972878_j_acph-2022-0011_ref_011","doi-asserted-by":"crossref","unstructured":"11. A. Ringborg, P. Lindgren, D. D. Yin, M. Martinell and J. Stalhammar, Time to insulin treatment and factors associated with insulin prescription in Swedish patients with type 2 diabetes, Diabetes Metab. 36 (2010) 198\u2013203; https:\/\/doi.org\/10.1016\/j.diabet.2009.11.00610.1016\/j.diabet.2009.11.00620347376","DOI":"10.1016\/j.diabet.2009.11.006"},{"key":"2026051108211972878_j_acph-2022-0011_ref_012","doi-asserted-by":"crossref","unstructured":"12. F. Persson, J. Bodegard, J. T. Lahtela, T. Nystrom, M. E. Jorgensen, M. L. Jensen, H. L. Gulseth, M. Thuresson, F. Hoti, D. Nathanson, A. Norhammar, K. I. Birkeland, J. G. Eriksson and J. W. Eriksson, Different patterns of second-line treatment in type 2 diabetes after metformin mono-therapy in Denmark, Finland, Norway and Sweden (D360 Nordic): A multinational observational study, Endocrinol. 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