More than 84 million people in America have diabetes or are on the verge of getting it, and 90% of these people have type 2 diabetes. Between 2002 and 2007, the cost of diabetes-related complications to the United States healthcare system more than doubled from $24.6 billion to $58 billion. In many cases, type 2 diabetes can be managed or avoided with lifestyle changes like weight loss and exercise. Unfortunately, many people with type 2 diabetes struggle to find the motivation needed to make these changes. As a result, they are experiencing life-altering complications such as heart attack, stroke, blindness, limb amputation, and kidney failure at alarming rates.
New Survey Data
A survey commissioned by Boehringer Ingelheim Pharmaceuticals and conducted by Sermo recently convened a multidisciplinary steering committee to assess attitudes about diabetes-related complications. It showed that complications are prevalent in type 2 diabetes. More than 40% of physicians surveyed said that over half of their patients develop at least one complication as a result of uncontrolled type 2 diabetes. Nearly all physicians surveyed (94%) believed that kidney health is an important consideration in understanding the risk of other complications, but 40% did not believe the majority of their newly diagnosed patients even know that type 2 diabetes can lead to kidney disease.
“To reduce the disease burden, complications related to type 2
diabetes must be decreased.”
Physicians participating in the survey reported that lack of motivation, lack of medication adherence, and an inability to lose weight were the most common reasons for ineffective control of their patients’ type 2 diabetes. Compliance with lifestyle modifications and medications and poor patient understanding were cited as the primary obstacles to preventing complications. Furthermore, while about two-thirds of physicians reported that they typically referred their patients to a dietitian/nutritionist and that these specialists were most helpful in assisting patients with weight loss, obesity rates continue to be high in these patients.
Areas for Opportunity
More than 80% of physicians surveyed believed that a team of specialists designated to help in the early stages of type 2 diabetes may help improve patient outcomes, and another 71% reported that a team approach is feasible for their practice. However, 93% did not believe their peers were utilizing this strategy. People with diabetes and the physicians/specialists who treat them would benefit from utilizing an integrated, team approach in the early stages of the disease because it may prevent or delay the onset of devastating complications. It behooves all constituents to develop clear, practical action plans that are aimed at keeping patients motivated while making the necessary lifestyle changes that are integral to controlling diabetes.
The findings of this survey highlight some significant needs in the diabetes management community. To reduce the disease burden, complications related to type 2 diabetes must be decreased. More patient-physician dialogue around kidney health is important because the kidney may be an independent predictor of other diabetes-related complications like heart disease. Minorities should also receive patient education that is directed specifically toward them; it’s well documented that African Americans and Hispanics are twice as likely to develop diabetes as Caucasians. The hope is that these survey findings serve as a call to action for the type 2 diabetes treatment community. By collaborating with patients and other specialists, physicians can make a significant impact by potentially preventing complications that affect millions of patients.
Sermo. Survey Analysis: Type 2 Diabetes Mellitus Treament. January 2010. For a press release on the survey results, go to: http://multivu.prnewswire.com/mnr/boehringeringelheim/42672/.
Friedman AN, Miskulin DC, Rosenberg IH, Levey AS. Demographics and trends in overweight and obesity in patients at time of kidney transplantation. Am J Kidney Dis. 2003;41:480-487.
American Diabetes Association. Standards of medical care in diabetes–2010. Diabetes Care. 2010;33(Suppl 1):S11-S61.
Dall TM, Zhang Y, Chen YJ, Quick WW, Yang WG, Fogli J. The economic burden of diabetes. Health Aff (Millwood). 2010;29:297-303.
Centers for Disease Control and Prevention. Team Care: Comprehensive Lifetime Management for Diabetes. Atlanta, Georgia: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2001. Available at: http://www.ndep.nih.gov/media/TeamCare.pdf.