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Insulin Dose Changes by PCPs and Endocrinologists

Clinical Diabetes; ePub 2017 Aug 23; Davidson, et al

Time limitations, not a lack of ability, appear to serve as an impediment to primary care physicians (PCPs) using insulin to treat patients with diabetes, researchers concluded after conducting a study involving 20 simulated patients. Investigators compared dose adjustment decisions made by PCPs (n=9) and endocrinologists (n=9) to the algorithms from a large safety-net clinic’s diabetes program. Among the results:

  • The number of dose changes was similar in both groups.
  • The amounts of the dose changes in the PCP group were significantly closer to algorithms than were the amounts in the endocrinologist contingent.

The authors suggested that time constraints of the current medical system may impact PCP willingness to start and intensify insulin therapy. They pointed to telemedicine as a potential solution.

Citation:

Davidson M, Duran P, Davidson J, Lee M. Comparison of insulin dose adjustments by primary care physicians and endocrinologists. [Published online ahead of print August 23, 2017]. Clinical Diabetes. doi:10.2337/cd17-0021.

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