The Functionally Refractory Patient in Diabetes—Prevalence and Predictors within Specialist Care Registries

A recent literature survey reviewed all published global registries, evaluating them for patient outcome data and characteristics. Using registry data to define the patient characteristics of refractory patients, the authors characterized the functionally refractory patient in diabetes and provided a predictive model to facilitate the recognition of such a patient in a specialist practice. At the specialist level, the authors have identified common predictive elements of a functional refractory status: insulin usage, greater number of microvascular complications, earlier age of onset and longer durations of diabetes, and greater complexity and number of therapies. This editorial provides a brief overview and commentary of the authors’ original descriptive literature review and findings.