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Effect of short‐term intensive insulin therapy on quality of life in type 2 diabetes

2010· article· en· W2121479490 on OpenAlexafffund
Christine Opsteen, Ying Qi, Bernard Zinman, Ravi Retnakaran

Bibliographic record

VenueJournal of Evaluation in Clinical Practice · 2010
Typearticle
Languageen
FieldMedicine
TopicDiabetes Management and Education
Canadian institutionsLunenfeld-Tanenbaum Research InstituteUniversity of TorontoMount Sinai Hospital
FundersCanadian Institutes of Health Research
KeywordsMedicineQuality of life (healthcare)Diabetes mellitusType 2 diabetesInsulinWorryInternal medicineType 1 diabetesDistressPhysical therapyAnxietyEndocrinologyPsychiatryNursingClinical psychology

Abstract

fetched live from OpenAlex

RATIONALE, AIMS AND OBJECTIVES: Short-term intensive insulin therapy (IIT) early in the course of type 2 diabetes can improve pancreatic beta-cell function and even induce normoglycemia that persists post-therapy. In spite of this benefit, insulin is often delayed until late in the course of disease partly because of its perceived negative impact on quality of life (QOL). Therefore, we sought to examine the effect of early implementation of short-term IIT on patient-reported QOL and treatment satisfaction. METHODS: A total of 34 patients with type 2 diabetes (5.9 ± 6.6 years duration, on zero to two oral antihyperglycaemic agents) underwent 4-8 weeks of IIT consisting of basal detemir and pre-meal insulin aspart. Patient-reported QOL, treatment satisfaction and symptom distress were assessed at baseline and post-IIT using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), Diabetes Quality of Life Measure (DQOL), and Diabetes Symptoms Checklist-Revised (DSC-R). RESULTS: There was a significant improvement in glycated haemoglobin post-IIT (mean 6.5% vs. 7%; P < 0.001). All 34 patients tolerated IIT well with no severe hypoglycaemia. Following IIT, the SF-36 showed a significant improvement compared to baseline in reported physical functioning (mean 88.2 vs. 83.3, P = 0.009), general health (69.4 vs. 65.6, P = 0.03), and general mental health (85.2 vs. 82.2, P = 0.04). The DQOL demonstrated a significant improvement in global health perception (P = 0.02), diabetes worry (P = 0.006) and treatment satisfaction (P = 0.007). The DSC-R revealed a significant improvement in the diabetes-related total symptom score (P = 0.01). CONCLUSIONS: Contrary to popular perception, a short course of IIT resulted in significant improvements in QOL and treatment satisfaction, demonstrating the patient acceptability of early insulin therapy.

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How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.035
metaresearch head score (Gemma)0.192
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.157
Threshold uncertainty score0.994

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0350.192
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.165
GPT teacher head0.548
Teacher spread0.383 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations26
Published2010
Admission routes2
Has abstractyes

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