Real World Evidence Eli Lilly and Company, 60 Margaret Street, Sydney, NSW, 2000, Australia.
HaaPACS GmbH, Schriesheim, Germany.
BMC Prim Care. 2024 Apr 22;25(1):124. doi: 10.1186/s12875-024-02390-9.
The purpose of this study was to understand the healthcare provider (HCP) perspective on the extent of suboptimal insulin dosing in people with diabetes (PwD), as well as specific challenges and solutions to insulin management.
An online survey of general practitioners and specialists (N = 640) who treat PwD in Germany, Spain, the United Kingdom, and the United States was conducted. Responses regarding HCP background and their patients, HCP perceptions of suboptimal insulin use, and challenges associated with optimal insulin use were collected. Categorical summary statistics were presented.
Overall, for type 1 diabetes (T1D) and type 2 diabetes (T2D), most physicians indicated < 30% of PwD missed or skipped a bolus insulin dose in the last 30 days (T1D: 83.0%; T2D: 74.1%). The top 3 reasons (other than skipping a meal) HCPs believed caused the PwD to miss or skip insulin doses included they "forgot," (bolus: 75.0%; basal: 67.5%) "were too busy/distracted," (bolus: 58.8%; basal: 48.3%), and "were out of their normal routine" (bolus: 57.8%; basal: 48.6%). HCPs reported similar reasons that they believed caused PwD to mistime insulin doses. Digital technology and improved HCP-PwD communication were potential solutions identified by HCPs to optimize insulin dosing in PwD.
Other studies have shown that PwD frequently experience suboptimal insulin dosing. Conversely, results from this study showed that HCPs believe suboptimal insulin dosing among PwD is limited in frequency. While no direct comparisons were made in this study, this apparent discrepancy could lead to difficulties in HCPs giving PwD the best advice on optimal insulin management. Approaches such as improving the objectivity of dose measurements for both PwD and HCPs may improve associated communications and help reduce suboptimal insulin dosing, thus enhancing treatment outcomes.
本研究旨在了解医疗保健提供者（HCP）对糖尿病患者（PwD）胰岛素剂量不足的程度的看法，以及胰岛素管理的具体挑战和解决方案。
对在德国、西班牙、英国和美国治疗 PwD 的普通医生和专家（N=640）进行了在线调查。收集了关于 HCP 背景及其患者、HCP 对胰岛素使用不足的看法以及与最佳胰岛素使用相关的挑战的回复。给出了分类总结统计数据。
总体而言，对于 1 型糖尿病（T1D）和 2 型糖尿病（T2D），大多数医生表示在过去 30 天内，PwD 漏注或跳过胰岛素剂量的情况<30%（T1D：83.0%；T2D：74.1%）。HCP 认为导致 PwD 漏注或跳过胰岛素剂量的前 3 个原因（除了不吃饭外）包括他们“忘记了”（bolus：75.0%；basal：67.5%）、“太忙/分心了”（bolus：58.8%；basal：48.3%）和“脱离正常作息”（bolus：57.8%；basal：48.6%）。HCP 报告了他们认为导致 PwD 误时注射胰岛素的类似原因。数字技术和改善 HCP-PwD 沟通被 HCP 认为是优化 PwD 胰岛素剂量的潜在解决方案。
其他研究表明，PwD 经常经历胰岛素剂量不足。相反，本研究的结果表明，HCP 认为 PwD 中胰岛素剂量不足的频率有限。虽然在本研究中没有进行直接比较，但这种明显的差异可能导致 HCP 难以就最佳胰岛素管理向 PwD 提供最佳建议。改善 PwD 和 HCP 剂量测量的客观性等方法可能会改善相关沟通，并有助于减少胰岛素剂量不足，从而提高治疗效果。
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