Prescribing insulin for diabetes, do endocrinologists have a financial incentive to do so?

Recent guidelines ignore newer oral diabetes agents like Avandia and Januvia.

Matthew Mintz criticizes this move, saying that this will lower the threshold for diabetes to begin insulin therapy.

He wonders if the endocrinologists, who authored the guidelines, have a financial motive to do so. Due to time constraints, primary care physicians do not have the inclination to manage insulin regimens, which can be complex and involving. In many cases, it is easer to consult a specialist to manage insulin-requiring diabetes. “Whereas endocrinologist see starting insulin therapy as common and easy,” says Dr. Mintz, “my perspective as a PCP is that patients do not want to take insulin and see it as an absolute last resort.”

Knowing this, what better way is there to generate revenue than to fundamentally alter the guidelines such that it will guarantee business to endocrinologists?

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