Division of Behavioral Surveillance, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Diabetes Complications. 2012 Jan-Feb;26(1):17-22. doi: 10.1016/j.jdiacomp.2011.11.005. Epub 2012 Jan 5.
People with type 2 diabetes may need insulin therapy to compensate for their underlying pathogenic abnormalities and to improve glycemic control. We examined trends of insulin use among US adults aged ≥40 years with type 2 diabetes.
We analyzed data from the Behavioral Risk Factor Surveillance System collected annually during 1995-2007. Insulin use was assessed by self-report. Log-linear regression analyses with a robust error variance estimator were performed to estimate the prevalence, prevalence ratios, and their 95% confidence intervals.
The overall crude and age-standardized proportion of insulin use decreased from 35% and 36% in 1995 to 23% and 22% in 2007, respectively. After adjustments for age, sex, race/ethnicity, education attainment, body mass index, and diabetes duration, the overall prevalence decreased from 33% to 22% (P<.0001 for linear trend). The decreasing rates were similar across sex (P=.23 for interaction between sex and survey year) and race/ethnicity (P=.35 for interaction between race/ethnicity and survey year).
The proportion of insulin use decreased from 1995 to 2007 among US adults aged ≥40 years. Continuing efforts may be needed to properly identify those who may need to initiate and maintain insulin therapy among patients with type 2 diabetes as medically indicated.
2 型糖尿病患者可能需要胰岛素治疗来弥补其潜在的病理异常，并改善血糖控制。我们研究了美国≥40 岁 2 型糖尿病患者中胰岛素使用的趋势。
我们分析了 1995-2007 年期间每年收集的行为风险因素监测系统数据。胰岛素使用情况通过自我报告评估。采用稳健误差方差估计的对数线性回归分析来估计流行率、流行率比及其 95%置信区间。
总体而言，1995 年未经年龄调整的胰岛素使用率为 35%，年龄标准化后为 36%，而 2007 年分别降至 23%和 22%。在调整了年龄、性别、种族/民族、教育程度、体重指数和糖尿病病程后，总体流行率从 33%降至 22%（线性趋势 P<.0001）。在性别（性别与调查年份之间的交互作用 P=.23）和种族/民族（种族/民族与调查年份之间的交互作用 P=.35）方面，下降率相似。
美国≥40 岁成年人中，从 1995 年到 2007 年，胰岛素使用率有所下降。可能需要继续努力，以便在医学上需要时，正确识别那些可能需要开始并维持 2 型糖尿病患者胰岛素治疗的人群。
