IRCCS MultiMedica, Milan, Italy.
Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
Diabetes Res Clin Pract. 2020 Mar;161:108053. doi: 10.1016/j.diabres.2020.108053. Epub 2020 Feb 5.
Due to the progressive nature of type 2 diabetes (T2DM), initiation of insulin therapy is very likely in the disease continuum. This article aims at highlighting the current situation with regard to insulin therapy in people with T2DM in Europe and at presenting the associated unmet need. Challenges for both people with T2DM and healthcare professionals include clinical inertia also derived from fear of hypoglycaemia, weight gain and injections as well as increased need for a comprehensive diabetes management. We compare national and international guidelines and recommendations for the initiation and intensification of insulin therapy with the real-world situation in six European countries, demonstrating that glycaemic targets are only met in a minority of people with T2DM on insulin therapy. Furthermore, this work evaluates currently recorded numbers of people with T2DM treated with insulin in Europe, the proportion not achieving the stated glycaemic targets and thus in need to enhance insulin therapy e.g. by a change in means of insulin delivery including, but not limited to, insulin pens, wearable mealtime insulin delivery patches, patch pumps, and conventional insulin pumps with continuous subcutaneous insulin infusion.
由于 2 型糖尿病（T2DM）的进展性质，在疾病进展过程中很可能需要开始胰岛素治疗。本文旨在强调欧洲 T2DM 患者胰岛素治疗的现状，并提出相关的未满足需求。T2DM 患者和医疗保健专业人员面临的挑战包括临床惰性，这也源于对低血糖、体重增加和注射的恐惧，以及对综合糖尿病管理的需求增加。我们比较了六个欧洲国家的胰岛素起始和强化治疗的国家和国际指南和建议与现实情况，结果表明，只有少数接受胰岛素治疗的 T2DM 患者达到了血糖目标。此外，这项工作评估了目前在欧洲接受胰岛素治疗的 T2DM 患者人数、未达到既定血糖目标的比例，因此需要加强胰岛素治疗，例如通过改变胰岛素给药方式，包括但不限于胰岛素笔、可穿戴餐时胰岛素给药贴片、贴片泵和带有连续皮下胰岛素输注的传统胰岛素泵。
