The International Diabetes Center, Minneapolis, Minnesota (Dr Cuddihy)
Scripps Whittier Diabetes Institute, La Jolla, California (Dr Philis-Tsimikas)
Diabetes Educ. 2011 Jan-Feb;37(1):111-23. doi: 10.1177/0145721710388426. Epub 2010 Dec 3.
The purpose of this study was to investigate the opinions of primary care physicians (PCPs) and diabetes specialists on their perceived role in tackling type 2 diabetes (T2D) and the challenges they face, particularly regarding insulin intensification.
Six hundred physicians from Germany, Japan, Spain, Turkey, the United Kingdom, and the United States were recruited to complete an online survey. Screening criteria included T2D patients seen per week (Europe/Japan: all ≥ 2; United States: PCPs ≥ 5; specialists ≥ 10) and years in practice (3-30 years).
Most physicians had seen an increase in TD2 patients in the past 5 years, and almost all agreed that the burden of diabetes is increasing. Notable proportions of PCPs never initiate/modify insulin and never/rarely intensify insulin. Main barriers to insulin intensification cited were lack of experience and lack of time to educate patients. Better collaboration between primary and secondary care was considered one of the most important factors in improving insulin treatment of T2D.
PCPs are less involved in the initiation and intensification of insulin than specialists; however, all physicians appreciate the need for increased PCP involvement. A multidisciplinary approach that includes using the skills of diabetes educators will assist physicians in improving management of T2D.
本研究旨在调查初级保健医生（PCP）和糖尿病专家对其在解决 2 型糖尿病（T2D）方面的作用的看法，以及他们所面临的挑战，特别是在胰岛素强化治疗方面。
从德国、日本、西班牙、土耳其、英国和美国招募了 600 名医生参与在线调查。筛选标准包括每周看诊的 T2D 患者人数（欧洲/日本：所有医生≥2；美国：PCP≥5；专家≥10）和行医年限（3-30 年）。
大多数医生在过去 5 年内看到 T2D 患者有所增加，几乎所有人都认为糖尿病的负担正在增加。相当一部分 PCP 从未开始/调整胰岛素，也从未/很少强化胰岛素。提到的胰岛素强化治疗的主要障碍是缺乏经验和缺乏时间对患者进行教育。更好地协调初级保健和二级保健被认为是改善 T2D 胰岛素治疗的最重要因素之一。
PCP 在胰岛素的起始和强化治疗方面的参与程度低于专家；然而，所有医生都认为需要增加 PCP 的参与。多学科方法包括利用糖尿病教育者的技能，将有助于医生改善 T2D 的管理。
