Therapeutic Research

Abstract

Background：A large proportion of people with type 2 diabetes（T2DM）remain uncontrolled on basal insulin. To investigate gaps in perception between patients and health care providers, we surveyed doctors, nurses, and diabetic patients under basal insulin therapy, and assessed differences in perception and behaviour regarding glycemic control and insulin therapy. Methods：We implemented a web‒based internet questionnaire between March 25 and April 18, 2016. Participants included 712 adult men and women patients 20 years of age or older who were being treated with basal insulin（81 with type 1 diabetes；631 with type 2 diabetes）, 221 physicians treating diabetic patients with basal insulin, and 110 nurses working with insulin therapy in departments of internal medicine or specialized diabetes/endocrinology departments. Results：A total of 30.2％ of patients had satisfactory glycemic control, and 37.2％ of those had experienced hypoglycemia within the previous 3 months. Only 55％ of patients were satisfied with their glycemic control, lower than the 69％ estimated by physicians. A total of 93.2％ of patients desired improvement of glycemic control, higher than estimated by physicians（73.3％）or nurses（64.9％）. About half of the patients had concerns about their condition: 72.5％ worried about complications, 48.9％ about hypoglycemia, and 43.0％ about glycemic variability. This suggests that physicians and nurses underestimate patient interest in diabetes management and overestimate treatment satisfaction. Patients wanted information on new treatment methods and basal insulin formulations, but physicians felt no need for such explanations. Conclusions：Patients were more concerned about hypoglycemia risk, wanted more stable glycemic control, and desired more information on new treatment methods and basal insulin formulations than physicians expected. Health care providers may be able to improve diabetes care by better understanding patient thoughts and hopes and by sharing that understanding with other team members. Funding：This survey was funded by Sanofi K. K.