García-Prieto Concha F, Gómez-Peralta Fernando, Villar-Taibo Rocío, Cinza-Sanjurjo Sergio, Redondo-Antón Jennifer, Díaz-Cerezo Silvia, Rubio-de Santos Miriam
Eli Lilly and Company, Avenida de la Industria 30, 28108, Alcobendas, Madrid, Spain.
Endocrinology and Nutrition Unit, Segovia General Hospital, Calle de Luis Erik Clavería, Segovia, Spain.
Endocrinol Diabetes Metab. 2025 Sep;8(5):e70095. doi: 10.1002/edm2.70095.
This study analysed the opinions and perceptions of Spanish physicians towards the management of people newly diagnosed with type 2 diabetes (T2D) aged ≤ 65 years.
Online survey targeting primary care physicians (PCPs) and endocrinologists (members of three national scientific societies) treating people with T2D. Management practices and factors determining prescribed therapies and treatment goals were captured in general and by patient profile. The respondents' perception of the limitations in setting strict glycaemic control objectives and weight loss targets, and the feasibility and impact of possible solutions, were examined.
A total of 105 physicians (60% PCPs, 40% endocrinologists) responded to the survey; 98% of respondents reported following clinical practice guidelines; 53.3% and 27.6% considered stringent glycaemic control to be HbA1c levels of 6.0%-6.5% and 6.5%-7.0%, respectively. In patient profiles with overweight/obesity, > 90% reported setting weight loss goals, with 5%-10% weight loss being the most common target. The most limiting factors for the establishment of stringent glycaemic and weight loss targets were the lack of awareness of self-care of the disease (74.3%) and the cost to the healthcare system of the most effective drugs (72.4%). Training and the implementation of simple protocols and algorithms were the solutions perceived as having the greatest impact and feasibility. Redefining visa criteria was considered the solution with the highest impact.
The results are consistent with clinical practice guidelines' recommendations in Spain, but early and intensive interventions focused on reducing the risk of long-term complications in people with T2D who have longer life expectancy could be promoted at diagnosis.
本研究分析了西班牙医生对年龄≤65岁的2型糖尿病（T2D）新诊断患者管理的意见和看法。
针对治疗T2D患者的基层医疗医生（PCP）和内分泌科医生（三个国家科学学会的成员）进行在线调查。从总体和患者资料方面获取管理实践以及决定处方治疗和治疗目标的因素。研究了受访者对设定严格血糖控制目标和体重减轻目标的局限性的看法，以及可能解决方案的可行性和影响。
共有105名医生（60%为基层医疗医生，40%为内分泌科医生）回复了调查；98%的受访者报告遵循临床实践指南；53.3%和27.6%的受访者分别认为严格血糖控制的糖化血红蛋白（HbA1c）水平为6.0% - 6.5%和6.5% - 7.0%。在超重/肥胖的患者资料中，>90%的受访者报告设定了体重减轻目标，5% - 10%的体重减轻是最常见的目标。建立严格血糖和体重减轻目标的最限制因素是患者对疾病自我护理的认识不足（74.3%）以及最有效药物对医疗系统的成本（72.4%）。培训以及实施简单的方案和算法被认为是影响最大且最可行的解决方案。重新定义签证标准被认为是影响最大的解决方案。
结果与西班牙临床实践指南的建议一致，但在诊断时可以推广早期和强化干预措施，重点是降低预期寿命较长的T2D患者长期并发症的风险。
