A study of 1000 people with type 2 diabetes and 300 physicians has revealed differences in the ways the two groups define diabetes control. While physicians almost all defined control in terms of measurable, clinical variables such as HbA1c and the frequency/severity of diabetes, people with the condition had a broader definition, including energy levels, mood and the amount of insulin required. Recognising and acting on these differences could lead to better and more individualised care.
The POC (Perception of Control) study was based on a web survey of 300 clinicians and 1012 adults with type 2 diabetes that was poorly controlled (HbA1c, >64 mmol/mol [8%]) whilst on basal insulin, as well as 295 adults with well-controlled type 2 diabetes. Physicians were more likely than their patients to define control in clinical terms such as frequency/severity of hypoglycaemia (93% vs. 69%), complications (89% vs. 75%) and HbA1c (85% vs. 79%). In comparison, although these clinical measures were also important to the people with type 2 diabetes, their definitions of control were more likely to include the amount of insulin units taken per day (78% vs. 29%, energy levels (75% vs. 33%) and how much they had to think about their condition (68% vs. 31%), amongst other factors.
People with type 2 diabetes also perceived a greater number of obstacles to achieving good control than physicians, including stress (75% vs. 54%), medicine side-effects (70% vs. 56%) and family obligations (61% vs. 33%). Furthermore, they identified a number of negative impacts of type 2 diabetes that occurred to few physicians, including mood/emotions (63% vs. 33%), making plans (62% vs. 16%) and how much they could accomplish during the day (62% vs. 23%).
Commenting on the study, said Meryl Brod, the lead investigator, said: “There is a significant gap in perceptions of control between physicians and patients in how they define control, the obstacles and how being uncontrolled on basal insulin impacts patients’ daily lives. Having a more open dialogue during consultations may provide more insight into these critical factors which could improve diabetes management and lead to more effective individualised treatment plans.”
These findings were presented at the 51st European Association for the Study of Diabetes (EASD) Annual Meeting, poster #890. More information can be found here.
