Divergence in Perceptions of Diabetes Control among Patients with T2DM and Health Care Professionals (HCPs)

Abstract

Background: Sixty percent of patients with T2DM on basal insulin have an A1C ≥7%. This study aimed to understand patient and HCP views of “control,” as this may impact how many patients reach an A1C<7%. Methods: A cross-sectional, web-based survey of 500 HCPs (primary care physicians, endocrinologists, nurse practitioners/physician assistants) and 618 adults with T2DM using basal insulin was conducted to assess perceptions, attitudes and behaviors associated with T2DM management. The survey was developed based on feedback from focus groups and piloted. Patients self-reported A1C and were asked to confirm the value with their HCP, if necessary. Results: Patients and HCPs differed on what it meant to be “in control.” A1C was used most often, but more frequently selected by HCPs (91% vs. 69%), followed by daily blood glucose meter readings (63% HCPs vs. 68% patients). Beyond A1C and daily blood glucose, patients most frequently used behavioral criteria (e.g., adherence to lifestyle changes and/or treatment regimens); HCPs most frequently used clinical criteria (e.g., hypoglycemia). The timeframe for defining control varied among patients, with those at A1C>8% more frequently reporting “the current moment” or “the past week.” Most HCPs focused on the last 3 months to define control (67% vs. 34% all patients, p<0.05). Patients also differed from HCPs regarding responsibility, being more likely to agree that controlling their diabetes is completely their (patients’) responsibility (34% HCPs vs. 67% patients, p<0.05). HCPs were more likely to agree that they (HCPs) have a responsibility to actively contribute to the control of their patients’ T2DM (90% vs. 60%, p<0.05). Conclusions: Patients with T2D in the U.S. have differing views from HCPs on key aspects of diabetes control and management, and are less likely to consider A1C value as a criterion for determining control. Recognizing these differences may improve communication, with the potential to improve patient outcomes. Disclosure M. Brod: Consultant; Self; Novo Nordisk A/S. K.J. Tomaszewski: Research Support; Self; Novo Nordisk Inc. A. Allen: Research Support; Self; Novo Nordisk Inc. D.F. Kruger: Research Support; Self; Dexcom, Inc.. Speaker's Bureau; Self; Dexcom, Inc.. Stock/Shareholder; Self; Dexcom, Inc.. Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Eli Lilly and Company, Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Intarcia Therapeutics, Inc., Abbott. Research Support; Self; Sanofi. Consultant; Self; Sanofi. Research Support; Self; JAEB Center For Health Research. Consultant; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; Hygieia, Lexicon Pharmaceuticals, Inc., National Institute of Diabetes and Digestive and Kidney Diseases. Speaker's Bureau; Self; Valeritas, Inc., Insulet Corporation. Consultant; Self; Insulet Corporation. Research Support; Self; Insulet Corporation. Consultant; Self; Merck & Co., Inc. M.K. Heile: Advisory Panel; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc., Insulet Corporation. Advisory Panel; Self; Dexcom, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Roche Diagnostics Corporation. M. Mocarski: Employee; Self; Novo Nordisk Inc.. Stock/Shareholder; Self; Novo Nordisk A/S. A. Schiffman: Employee; Self; Novo Nordisk Inc. Y. Handelsman: Consultant; Self; Amarin Corporation. Speaker's Bureau; Self; Amarin Corporation. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Amgen Inc.. Research Support; Self; Amgen Inc.. Speaker's Bureau; Self; Amgen Inc.. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Gan & Lee Pharmaceuticals. Consultant; Self; Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Lexicon Pharmaceuticals, Inc.. Consultant; Self; Merck & Co., Inc.. Research Support; Self; Merck & Co., Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc., Regeneron Pharmaceuticals, Inc.. Consultant; Self; Sanofi. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi.