Chen Roger, Aamir Azizul Hasan, Feroz Amin Mohammod, Bunnag Pongamorn, Chan Siew Pheng, Guo Lixin, Khamseh Mohammad E, Mohan Viswanathan, Nicodemus Nemencio, Roberts Anthony, Tarigan Tri Juli Edi, Won Kyu-Chang, Mehta Roopa
Department of Endocrinology, St Vincent's Hospital, 406 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
University of New South Wales, Sydney, Australia.
Diabetes Ther. 2024 Jun;15(6):1261-1277. doi: 10.1007/s13300-024-01568-9. Epub 2024 Apr 16.
The rising prevalence of type 2 diabetes (T2D) is posing major challenges for the healthcare systems of many countries, particularly in the Asia-Pacific Region, in which T2D can present at younger ages and lower body mass index when compared with Western nations. There is an important role for insulin therapy in the management of T2D in these nations, but available evidence suggests that insulin is under-utilized and often delayed, to the detriment of patient prognosis. The authors of this article gathered as an advisory panel (representative of some of the larger Asia-Pacific nations) to identify their local barriers to insulin use in T2D, and to discuss ways in which to address these barriers, with their outputs summarized herein. Many of the key barriers identified are well-documented issues of global significance, including a lack of healthcare resources or of an integrated structure, insufficient patient education, and patient misconceptions about insulin therapy. Barriers identified as more innate to Asian countries included local inabilities of patients to afford or gain access to insulin therapy, a tendency for some patients to be more influenced by social media and local traditions than by the medical profession, and a willingness to switch care providers and seek alternative therapies. Strategies to address some of these barriers are provided, with hypothetical illustrative case histories.
2型糖尿病（T2D）患病率的不断上升给许多国家的医疗保健系统带来了重大挑战，尤其是在亚太地区。与西方国家相比，该地区T2D发病年龄更小，体重指数更低。胰岛素治疗在这些国家的T2D管理中发挥着重要作用，但现有证据表明胰岛素使用不足且往往延迟，这对患者预后不利。本文作者作为一个咨询小组（代表一些较大的亚太国家）聚集在一起，以确定他们当地T2D胰岛素使用的障碍，并讨论解决这些障碍的方法，其成果总结如下。所确定的许多关键障碍是具有全球意义的、有充分记录的问题，包括缺乏医疗资源或综合结构、患者教育不足以及患者对胰岛素治疗的误解。被认为在亚洲国家更为内在的障碍包括患者在当地无力负担或无法获得胰岛素治疗、一些患者更容易受到社交媒体和当地传统的影响而非医学专业的影响，以及愿意更换医疗服务提供者并寻求替代疗法。本文提供了一些解决这些障碍的策略，并配有假设性的说明性病例史。
