The underuse of insulin therapy in North America
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
At least 8% of the combined population of the United States (US) and Canada have diabetes, and in about one-third of these people, the disease is undiagnosed [1]. Diabetes is not evenly distributed geographically, and there is surprisingly little consensus among categories of medical providers as to when and how intensive insulin therapy should be initiated. Although some physicians worry that insulin therapy may promote insulin resistance or increase the risk of cardiovascular events, the best current clinical evidence suggests that such fears are largely unfounded. Similarly, new evidence shows that the weight gain associated with insulin therapy is by no means always dramatic or progressive. The view that insulin is not effective in type 2 diabetes, although common in the US, is not shared by physicians experienced and skillful in its use and is refuted by recent clinical studies. Promising new patterns of insulin use in type 2 patients are emerging in the US: the availability of insulin as a single dose, rather than moving directly to multiple daily injections; the practice of continuing rather than stopping oral agents when an evening insulin dose is added; and the use of new insulins and insulin-sensitizing agents that facilitate therapy and increase its effectiveness. Several new treatment options are discussed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it