Insulin therapy in type 2 diabetes is no longer a secondary care activity in the Netherlands

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• 作者：Marië ; lle J.P. van Avendonk ; Kees J. Gorter ; Maureen van den Donk ; Guy E.H.M. Rutten
• 关键词：Primary care ; Diabetes mellitus type 2 ; Insulin therapy
• 刊名：Primary Care Diabetes
• 出版年：2009
• 出版时间：February 2009
• 年：2009
• 卷：3
• 期：1
• 页码：23-28
• 全文大小：225 K

文摘

Aim

Because Dutch health care organisations did want to establish well-defined diabetes shared care groups, we investigated the organisation of insulin therapy in general practice in the Netherlands and assessed factors that were associated with providing insulin therapy in type 2 diabetes (DM2) patients.

Methods

Questionnaire to half of the Dutch general practitioners (GPs) (n = 3848). We compared GPs who both start insulin treatment and monitor the dosages with those who always refer patients requiring insulin therapy or only monitor insulin dosages.

Results

Total response was 42 % (n = 1621). 67 % of the GPs start insulin therapy in patients with DM2, especially male GPs and those above the age of 40, as well as GPs working in a health centre and those working together with a practice nurse. GPs working in urban regions less often start insulin. The most often mentioned barriers for starting and/or monitoring insulin therapy are lack of knowledge of insulin therapy, lack of time and insufficient financial incentives.

Conclusion

This nation-wide overview shows that insulin therapy is no longer a secondary care based activity. However, there is still need to enlarge the practice staff and to overcome the perceived skills deficit.