Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
J Clin Endocrinol Metab. 2022 Aug 18;107(9):2424-2432. doi: 10.1210/clinem/dgac420.
J-DISCOVER is a prospective observational cohort study aiming to understand the current management of patients with early-stage type 2 diabetes mellitus (T2DM) in Japan, enrolling patients initiating second-line treatment.
The current analysis examined the change in treatment satisfaction during the study period and factors affecting this change among patients in J-DISCOVER.
We used data from the J-DISCOVER study, in which 1798 patients with T2DM aged ≥ 20 years were enrolled from 142 sites across Japan. Treatment satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQ).
The mean DTSQ treatment satisfaction score increased from 25.9 points at baseline to 27.3 points at 6 months, which was maintained through 36 months. Among the baseline characteristics examined, higher baseline DTSQ treatment satisfaction scores (P < 0.0001), older age (≥ 75 vs < 65 years, P = 0.0096), living alone (P = 0.0356), and type of facility (clinics vs hospitals, P = 0.0044) had a significantly negative impact on the changes in DTSQ treatment satisfaction scores. Improvement in mean glycated hemoglobin (HbA1c) from baseline (7.7%) to 36 months (7.1%) was associated with positive changes in the DTSQ treatment satisfaction score (P = 0.0003).
Changes in DTSQ treatment satisfaction scores were related to HbA1c improvement, suggesting that the management strategy was appropriately planned for each patient. The results also suggest that the availability of social support for patients with T2DM who are elderly or living alone may be an important factor affecting treatment satisfaction, adherence, and clinical outcomes.
J-DISCOVER 是一项前瞻性观察性队列研究,旨在了解日本早期 2 型糖尿病(T2DM)患者的当前治疗管理情况,纳入开始二线治疗的患者。
本分析检查了 J-DISCOVER 研究期间治疗满意度的变化,以及影响患者治疗满意度变化的因素。
我们使用了来自 J-DISCOVER 研究的数据,该研究共纳入了来自日本 142 个地点的 1798 名年龄≥20 岁的 T2DM 患者。使用糖尿病治疗满意度问卷(DTSQ)评估治疗满意度。
DTSQ 治疗满意度评分从基线的 25.9 分增加到 6 个月时的 27.3 分,并维持至 36 个月。在检查的基线特征中,较高的基线 DTSQ 治疗满意度评分(P<0.0001)、年龄较大(≥75 岁与<65 岁,P=0.0096)、独居(P=0.0356)和治疗机构类型(诊所与医院,P=0.0044)对 DTSQ 治疗满意度评分的变化有显著的负面影响。从基线(7.7%)到 36 个月(7.1%)平均糖化血红蛋白(HbA1c)的改善与 DTSQ 治疗满意度评分的正向变化相关(P=0.0003)。
DTSQ 治疗满意度评分的变化与 HbA1c 的改善有关,这表明针对每位患者的治疗管理策略是适当的。研究结果还表明,对于年龄较大或独居的 T2DM 患者,社会支持的可用性可能是影响治疗满意度、依从性和临床结局的重要因素。