Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

doi:10.4239/wjd.v15.i5.828

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May 15, 2024 (publication date) through Mar 21, 2026

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World Journal of Diabetes

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Diabetes. May 15, 2024; 15(5): 828-852
Published online May 15, 2024. doi: 10.4239/wjd.v15.i5.828

Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

Mahmoud Emad-Eldin, Gehan F Balata, Eman A Elshorbagy, Mona S Hamed, Mohamed S Attia

Mahmoud Emad-Eldin, Department of Pharmacy Practice, Faculty of Pharmacy, Zagazig University, Zagazig HFQM+872, Al-Sharqia Governorate, Egypt

Gehan F Balata, Department of Pharmacy Practice, Faculty of Pharmacy, Heliopolis University, Cairo 44519, Egypt

Gehan F Balata, Mohamed S Attia, Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Al-Sharqia Governorate, Egypt

Eman A Elshorbagy, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Al-Sharqia Governorate, Egypt

Mona S Hamed, Department of Community at Faculty of Medicine, Zagazig University, Zagazig 44519, Al-Sharqia Governorate, Egypt

Author contributions: Emad-Eldin M conducted the literature search, interpreted the relevant literature, and drafted the initial manuscript; Hamed MS conceived the idea and designed the paper; Balata GF and Elshorbagy EA contributed to the drafting of the manuscript and provided input on the overall concept; Attia MS prepared the figures, provided critical intellectual input during the article revision and review/editing of the manuscript; all authors have reviewed and approved the final version of the manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Mahmoud Emad-Eldin, BPharm, MSc, Teaching Assistant, Department of Pharmacy Practice, Faculty of Pharmacy, Zagazig University, PO 44519, Zagazig HFQM +872, Al-Sharqia Governorate, Egypt. memadeldin@zu.edu.eg

Received: December 25, 2023
Peer-review started: December 25, 2023
First decision: January 10, 2024
Revised: February 1, 2024
Accepted: March 20, 2024
Article in press: March 20, 2024
Published online: May 15, 2024
Processing time: 137 Days and 4.1 Hours

Abstract

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses. Over the past century, insulin formulations have undergone significant modifications and bioengineering, resulting in a diverse range of available insulin products. These products show distinct pharmacokinetic and pharmacodynamic profiles. Consequently, various insulin regimens have em-erged for the management of type 2 diabetes, including premixed formulations and combinations of basal and bolus insulins. The utilization of different insulin regimens yields disparate clinical outcomes, adverse events, and, notably, patient-reported outcomes (PROs). PROs provide valuable insights from the patient’s perspective, serving as a valuable mine of information for enhancing healthcare and informing clinical decisions. Adherence to insulin therapy, a critical patient-reported outcome, significantly affects clinical outcomes and is influenced by multiple factors. This review provides insights into the clinical effectiveness of various insulin preparations, PROs, and factors impacting insulin therapy adherence, with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

Keywords: Adherence; Diabetes; Insulin; Patient-reported outcomes; Pharmacokinetic; Pharmacodynamic

Core Tip: Understanding the dynamics of insulin therapy in type 2 diabetes is crucial for the effective management of the disease. This review navigates through the evolution of insulin formulations, emphasizing the impact of different regimens on patient-reported outcomes. Adherence to insulin therapy, a pivotal factor for successful outcomes, is investigated alongside various insulin preparations and the influencing factors. Gaining insight into these dynamics can steer healthcare strategies, ultimately refining decision-making and boosting patient outcomes in type 2 diabetes management.