Patients’ empowerment , physicians’ perceptions, and achievement of therapeutic goals in patients with type 1 and … – Dove Medical Press

Fernando J Lavalle-González,¹ Erwin Chiquete²

On behalf of the IDMPS-3W Collaborative Group (Mexico)

¹Department of Endocrinology, Hospital Universitario Dr José Eleuterio González, Monterrey, NL, ²Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Background: Physicians’ perception could not parallel target measures of therapeutic targets in patients along with diabetes. This is a problem rarely addressed in the medical literature. We aimed to analyze physicians’ perception and characteristics of adequate manage of patients along with diabetes.
Patients and methods: We researched post regard physicians and their patients that participated in the 3rd wave of the Worldwide Diabetes Management Practices Study registry in Mexico. This analysis was executed regard 2,642 patients, 203 along with form 1 diabetes mellitus (T1DM) and 2,439 along with form 2 diabetes mellitus (T2DM), treated by 200 physicians.
Results: The patients perceived at goal had lesser hemoglobin A1c (HbA1c) and fasting blood sugar compared to those considered not at target. However, overestimation of the frequency of patients along with HbA1c <7% was 41.5% in patients along with T1DM and 31.7% in patients along with T2DM (underestimation: 2.8% and 8.0%, respectively). The agreement in between the physicians’ perception and the class of HbA1c was suboptimal (κ: 0.612). Diabetologists and endocrinologists tested HbA1c a lot more often compared to primary care practitioners, internists, or cardiologists; however, no differences were observed in mean HbA1c, for the 2 T1DM (8.4% vs 7.2%, P=0.42) and T2DM (8.03% vs 8.01%, P=0.87) patients. Nevertheless, insulin users perceived at target, that practiced self-monitoring and self-adjustment of insulin, had a lesser mean HbA1c compared to patients free of these characteristics (mean HbA1c in T1DM: 6.8% vs 9.6%, respectively; mean HbA1c in T2DM: 7.0% vs 10.1%, respectively).
Conclusion: Even though there is a substantial physicians’ overestimation regarding the perfect glycemic control, this global impression and characteristics of patients’ empowerment, such as self-monitoring and self-adjustment of insulin, are associated along with the achievement of targets.

Keywords: A1c, care, diabetes, HbA1c, goal, IDMPS, insulin, management, Mexico, opinion, self-monitoring, address to target

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