Simacek Kristina, Curran Christopher, Fenici Peter, Garcia-Sanchez Ricardo
PatientsLikeMe, Inc., Cambridge, MA, USA,
AstraZeneca, Cambridge, UK.
Patient Prefer Adherence. 2019 Feb 18;13:295-307. doi: 10.2147/PPA.S186801. eCollection 2019.
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).
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.
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.
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.
本研究旨在评估国际样本中2型糖尿病（T2D）患者对糖化血红蛋白（A1C）检测及其目标值的知晓情况、血糖控制的感知水平和并发症风险、对药物及自我管理的态度，以及与治疗方案相关的困扰。
这项描述性研究对美国、加拿大、英国、德国、西班牙和墨西哥在线健康社区中自我报告经医生诊断为T2D的成年人进行了单时间点调查。
共有661名患者参与。各国患者对其上次检测的A1C值的知晓情况差异很大（42%-89%），对有A1C目标值的知晓情况亦是如此（26%-70%）。美国、加拿大和欧洲受访者自我报告的A1C值相似（平均为6.8%-7.3%）。这些国家约三分之二的受访者（66%-71%）报告称其T2D得到了很好或较好的控制，很少有人（5%-15%）预计在1年内会出现严重并发症。然而，许多受访者预计在此时间段内会出现微血管（而非大血管）并发症（例如，神经疼痛，5%-47%）。自我报告的口服药物依从性普遍较高，大多数受访者（86%-98%）按照医疗保健提供者的指示服用药丸或片剂，不过美国（71%）和墨西哥（78%）的胰岛素注射依从性低于其他国家（86%-95%）。各国大多数受访者（71%-79%）报告称注射药物一点也不麻烦或只是有点麻烦。各国受访者似乎相当有信心能够充分控制血糖水平；尽管如此，仍有相当一部分人（21%-35%）存在临床显著水平的与治疗方案相关的困扰。
患者对其A1C值以及T2D控制不佳的潜在并发症（尤其是心血管并发症）的认知有限，可能是一个普遍存在的问题。此外，可能需要更多的患者支持来改善T2D的自我管理并减少与治疗方案相关的困扰。
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