Patient perceptions of their glycemic control and its influence on type 2 diabetes outcomes: an international survey of online communities
Received 22 September 2018
Accepted for publication 23 January 2019
Published 18 February 2019 Volume 2019:13 Pages 295—307
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Kristina Simacek,1 Christopher Curran,1 Peter Fenici,2 Ricardo Garcia-Sanchez3
1PatientsLikeMe, Inc., Cambridge, MA, USA; 2AstraZeneca, Cambridge, UK; 3AstraZeneca, Gaithersburg, MD, USA
Purpose: This study aimed to assess awareness of glycated hemoglobin (A1C) testing and targets, perceived level of glycemic control and risk of complications, attitudes toward medications and self-management, and regimen-related distress in an international sample of patients with type 2 diabetes (T2D).
Methods: The descriptive study used a single time-point survey of adults in online health communities in the USA, Canada, the UK, Germany, Spain, and Mexico, who self-reported T2D diagnosed by a physician.
Results: In total, 661 patients participated. Awareness of their A1C value at last test varied considerably between countries (42%–89%), as did awareness of having an A1C target (26%–70%). Self-reported A1C values were similar across US, Canadian, and European respondents (mean, 6.8%–7.3%). Approximately two-thirds of respondents from these countries (66%–71%) reported that their T2D was very or fairly well controlled, and few (5%–15%) expected to experience serious complications within 1 year. However, many respondents expected to experience microvascular (rather than macrovascular) complications in this time frame (eg, nerve pain, 5%–47%). Self-reported adherence to oral medication was generally high, with most respondents (86%–98%) taking their pills or tablets as directed by their healthcare provider, although for insulin injections adherence was lower in the USA (71%) and Mexico (78%) than in the other countries (86%–95%). The majority of respondents across countries (71%–79%) reported that taking injectable medications was not at all or a little burdensome. Respondents across countries appeared to be reasonably confident that they could adequately manage their blood sugar levels; despite this, a sizeable minority (21%–35%) had clinically significant levels of regimen-related distress.
Conclusion: Limited patient awareness of their A1C value and the potential complications of poorly controlled T2D, particularly regarding cardiovascular complications, may be a widespread problem. Furthermore, greater patient support may be needed to improve self-management of T2D and to reduce regimen-related distress.
Keywords: diabetes mellitus, type 2, diabetes complications, glycated hemoglobin, self-management, surveys
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