Adults with Type 2 are more willing to take action to achieve A1C Targets

Type 2
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Surveys Find Adults with Type 2 Diabetes Are More Willing to Take Action to Achieve A1C Targets Quicker than Physicians and Other Medical Professionals Perceive

– Findings reveal that some patients are frustrated and discontinued medication because they were not reaching their individualized A1C target quick enough –

Jacksonville, FL – July 20, 2016 – The American Association of Clinical Endocrinologists (AACE) today announced results of two online surveys, conducted with support from Sanofi US, that identified differences in perceptions among adults living with type 2 diabetes as well as endocrinologists, primary care physicians and other medical professionals including nurse practitioners, physician assistants and pharmacists. The Perspectives in Diabetes Care surveys revealed that patients are more willing to take action to reach their individualized average blood glucose, or A1C, targets quicker than physicians and other medical professionals believe. More than half of adults living with type 2 diabetes polled are very willing to visit their physicians and other medical professionals more often and make multiple medication changes in order to achieve their A1C targets quicker, while less than one in five physicians and other medical professionals believe that patients would be very willing to take these actions.

Specifically, these findings reveal:
· While 57 percent of adults living with type 2 diabetes would be very willing to visit their physicians and other medical professionals more often, only 19 percent of physicians and other medical professionals polled believe they would be willing to do so.

· In addition, 52 percent of adults living with type 2 diabetes would be very willing to make multiple medication changes, though only 16 percent of physicians and other medical professionals think they would be very willing to make these changes.

“The disconnect uncovered by these surveys illustrates that patients are frustrated by not achieving their A1C target and are willing to accelerate the treatment process if it means reaching it more quickly,” said George Grunberger, M.D., FACP, FACE, Immediate Past President, American Association of Clinical Endocrinologists (AACE). “Physicians should ensure they are effectively addressing patients’ therapeutic goals when it comes to determining treatment plans, and recognize that for certain patients, early and intensive treatment – in accordance with the AACE diabetes guidelines and algorithm, which recommend re-evaluating patients every three months and intensifying diabetes treatment if their A1C is not at target – is the appropriate approach.”

These differing perceptions could play a role in the length of time it takes some patients to achieve their individualized A1C targets. The implications could be significant as more than 42 percent of patients surveyed have yet to achieve their A1C target and 77 percent of these respondents want to achieve it more quickly.

Frustration Grows as Time Increases

For respondents who had yet to achieve their individualized A1C target, frustration levels doubled after one year of treatment compared to after three months of treatment.

· Among patients surveyed, 22 percent have stopped taking their diabetes medication without talking to their physician or other medical professional; and

· Of those, more than one-third (38 percent) reported doing so because they were not reaching their A1C target quick enough, contributing to additional challenges for the physicians and other medical professionals responsible for their care.

“These findings demonstrate the importance of ensuring that patients, physicians and other medical professionals are collaboratively addressing the challenges that exist in reaching as well as maintaining glycemic control, and considering different approaches where appropriate,” said Chris Kaplan, North America Region Head, Diabetes & Cardiovascular Business Unit, Sanofi. “Our collaboration with AACE underscores our commitment to the clinicians who treat patients with diabetes and addressing their unmet needs.”

Physicians and other medical professionals can visit the Glycemic Explorer website at www.glycemicexplorer.com to learn more about why a proactive approach to treatment might be right for some type 2 diabetes patients.

About the Surveys
The surveys polled 1,000 adults living with type 2 diabetes who were diagnosed with diabetes from one to five years ago as well as 1,004 physicians (e.g., endocrinologists and primary care physicians) and other medical professionals (e.g., nurse practitioners, physician assistants and pharmacists) in the U.S.

About AACE
The American Association of Clinical Endocrinologists is a professional community of physicians specializing in endocrinology, diabetes and metabolism committed to enhancing the ability of its members to provide the highest quality of patient care. With headquarters in Jacksonville, Florida, AACE has over 6,500 members in the United States and 90 other countries.

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Disconnects between patients’ attitudes and doctors’ perceptions of their attitudes are nothing new. It’s an endemic problem of long standing. Another example: a few years ago I saw a survey of doctors and their patients in which two-thirds of the doctors said they refrained from prescribing insulin because their patients were afraid of needles (note: not because it wasn’t the appropriate therapy!). In the same survey, only about one-third of their patients said the idea bothered them.

It’s the age-old problem of “ASSUMing” . . .

Seems like the more things change, the more they stay the same . . . sigh. :worried:

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Oh, a footnote to the above: that survey wasn’t just of American doctors. It included doctors and patients from several countries, and the responses varied only very slightly. So it didn’t seem to be cultural but rather a basic element of medical thinking.

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The title seemed promising, but the report write-up not so much. Visiting the referenced https://www.glycemicexplorer.com/ (sponsored by Sanofi & aimed at physicians) offers no information about promoting a healthier diet or fitness regimen.

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I agree that the site is aimed toward pharmaceuticals, per the sponsors’ preferences, but (playing devil’s advocate here), the target of that site is patients that have an HbA1c>8.0. Following ADA and AACE guidelines, those patients are expected to be prescribed some type or types of medications, rather than only make lifestyle changes. (Please don’t argue the point of whether or not one or another diet/exercise regimen will manage those patients without medications – that is a topic that certainly gets plenty of air-time!)

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Diet and exercise gets a lot of air time? Not nearly enough.

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Doctors and patients suffer from the same problem most marriages, workplaces, and other relationships. We need to communicate better! This no great surprise.

Doctors need to understand that they do not bear the entire responsibility for treatment success. But neither does the patient. Doctors (and patients) need to listen better and don’t assume that treatment failure cannot simply be attributed to patient noncompliance. This diabetes thing is a lot harder than it looks.

Doctors need to be willimg to try some of the patient’s treatment ideas. Doctors may be surprised at the ideas and wisdom born with living with diabetes 8760 hours every year. How many hours did it take to become a doctor?

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They spend that many hours a year being doctors too, after they become one.

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I meant on the forums - not the general media.

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[quote=“Terry4, post:7, topic:54934, full:true”]Doctors (and patients) need to listen better and don’t assume that treatment failure cannot simply be attributed to patient noncompliance.
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Sometimes, “treatment success” needs to be attributed to patient noncompliance! (I’d still on a sliding scale, if I’d complied…)

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Except the ones who golf on Wednesdays. :sunglasses:

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Somehow I think living in a body with diabetes is qualitatively different in degree than a career choice.

It’s like ham and eggs; the chicken is involved but the pig is committed.

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Exactly.

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Actually I meant this forum too. There are many good and important discussion on insulin , using it, dosing and supplies which are wonderful

But very few discussions from those who are non insulin dependant on this site.
Except for maybe Judith. To me as a T2’ not on meds, there is very little I can relate to.
So how many out there are not insulin dependant?

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I suspect you might not find too many people who’ve ever lived with a doctor who consider it just a ‘career choice’

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As I’ve mentioned before, I’m willing to to relate on things we do have in common. I’m still willing to. I ran a half marathon just last week. It was my first. If you’d like to talk about running with diabetes, I’d be happy to talk about it. Have you considered starting a thread about running and how it helps with diabetes management? I’d be interested in your perspective and actually believe I could likely learn from it.

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I don’t mean to demean the devotion people can feel as they pursue their professions. I still maintain that living with a medical condition is qualitatively different than a person who studies it – it’s called skin in the game.

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Absolutely. An individual with diabetes has ALL of their skin in the game. Their doctor probably only understands 1% of what they do in terms of their individual management. However, when multiplied by the thousands of patients they have, it turns out to be a lot of skin after all… So while they don’t and never will know an individuals situation with diabetes as well as that person does, it’s pretty unfortunate to dismiss their collective expertise spread across thousands of patients and usually many years of practice… I’m afraid that’s a trend that has become sometimes excessively prevalent on this forum lately… And I am somewhat alarmed by it, but that’s just me…

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I plead guilty. I believe that doctors play a serious and beneficial role in helping me manage my diabetes. I do not have the broader perspective of being able to bring meaning to reading my lab results. It’s nice to be able to access their broad clinical experience when I raise an issue that I have no background on.

What chafes me, however, is when a clinician dismisses my experience as being merely anecdotal. My biggest gains and breakthroughs with living with diabetes did not come through my seeing the endo 4x/year for 28 years. When I was in metabolic crisis, they brought nothing to the table. Zip … nada. They just seemed to me to be there with their clipboards documenting my downhill slide and impending demise.

Not a word about limiting carbs. No talk about the law of small numbers. It wasn’t until I did my own investigation, found this site, and learned that there were other techniques for dealing with diabetes. For 28 years, all I got was a quarterly conversation and Rx refills.

And when I raised some of the breakthroughs I made, there was a palpable disinterest. Just saying.

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Thanks on the running part although I reached my goal of doing a run at 70 )
Came in first in my age group LOL. But my body is complaining and I have found a race walking class, which seems to work better and still exercise.
What I find there is not much discussion about, is that I constantly monitoring my carb intake to make sure I don’t go over 120 and still exercise. As obsessive as those who dose insulin. But for me there is no correction I don’t go high, not an option. Not at all complaining because it works very well for me, last A1c 5.6 .
Must be some one else who does this way.
Apologies just a bit if a rant ; )
Back to normal