Uncontrolled diabetes negatively affects millions of people in the United States and contributes to significant health burden. Many people with diabetes require high insulin doses to achieve glycemic control, but glycemia in this group has historically been difficult to manage. This retrospective, case-control study evaluated which therapeutic interventions and patient factors were associated with an improvement in A1C in people with type 2 diabetes using high-dose insulin at a county health system serving primarily low-income patients. Medication nonadherence was found to be the most influential factor affecting glycemic control in these individuals.

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