The NDMG of 2014 and further guidelines that were issued after the end of the period analyzed in this study recommend that insulin therapy should begin with intermediate-acting insulin and/or basally supported oral antidiabetic therapy. The documented prescribing behavior deviates from the guidelines in question and from the guideline issued by the German Federal Joint Committee (G-BA) in 2024. In all but one of the guidelines, intensified conventional insulin therapy is recommended restrictively or only in case of demonstrated absolute insulin deficiency. The analyzed data do not permit any conclusion as to whether insulin was prescribed for proper indications. The care situation indicates that prescribing behavior is partly not in conformity with the guidelines. The analysis had only limited ability to account for complex treatment regimens. There is a need for further research on regional care structures and guideline implementation.
Mertes et al. (2026) studied this question.