New data reveal why physicians and people with type 2 diabetes uncontrolled on basal insulin are reluctant to intensify insulin therapy

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Results from the Perceptions of Control (POC) study showed that
people with type 2 diabetes uncontrolled on basal insulin were
reluctant to intensify insulin therapy due to concerns such as
medication side effects, perceptions of getting sicker and not
wanting to add more injections. Physicians' concerns around insulin
intensification included a lack of patient agreement to intensify
insulin therapy, hypoglycaemia and patients' cognitive status.[1]
Findings from the Perceptions of Control study which evaluated the
perceptions of diabetes control amongst patients and physicians were
presented today at the World Diabetes Congress of the International
Diabetes Federation (IDF).

"A better understanding of how patients and physicians make
decisions around insulin intensification could significantly improve
communication during consultations and help people with type 2
diabetes, uncontrolled on basal insulin, to intensify treatment when
needed," said Meryl Brod, PhD, lead investigator of the POC study.
"Addressing patient concerns with additional information and
treatment options may lead to an increased number of patients
agreeing to change their treatment to get into better control."

The POC study results showed that people with type 2 diabetes
uncontrolled on basal insulin were apprehensive to intensify therapy
and initiate basal-bolus insulin despite their physician's
recommendation due to factors such as fear of weight gain caused by
the medication (45%), feeling they were getting sicker (44%), fear of
hypoglycaemia (low blood sugar) (41%) and not wanting to add more
injections (41%).[1] In total, over half (57%) were only somewhat or
not at all willing (39% somewhat / a little willing, 18% not at all
willing) to add one additional daily injection of bolus insulin to
help control their type 2 diabetes and 37% were concerned that the
regimen would be too complicated.[1]

Physician study participants reported that the primary reason they
were reluctant to intensify insulin therapy for people with type 2
diabetes uncontrolled on basal insulin was due to thinking their
patients would not agree (62%).[1] Physicians were also reluctant to
intensify therapy due to concerns around hypoglycaemia (46%),
especially if it was particularly dangerous in a patient's workplace
(54%).[1] Physicians were also concerned about recommending
intensification if a patient had a mental illness or altered mental
status (48%),[1] poor cognitive skills (46%) and concerns of patient
compliance (41%).[1]

About the Perceptions of Control (POC) Study

The POC study was based on information collected from a web survey
of 300 physicians and 1,012 adults with type 2 diabetes uncontrolled
on basal insulin (physician-confirmed HbA1c> 8% (64 mmol/mol)) from
the UK (n=100 physicians and 620 patients), Sweden (n=100 physicians
and 240 patients) and Switzerland (n=100 physicians and 152
patients). Information was also collected from a control group of 295
adults with type 2 diabetes controlled on basal insulin
(physician-confirmed HbA1c <7.5% (59 mmol/mol) from the UK. In total,
data were collected from 1,607 patients and physicians for
analysis.[1]-[3] The purpose of the study was to explore how
physicians and people with type 2 diabetes define control, identify
obstacles to achieving control,[2],[3] perceive the impact of
uncontrolled type 2 diabetes on daily life[2],[3] and reluctance to
intensify insulin therapy.[1]

About Novo Nordisk

Novo Nordisk is a global healthcare company with more than 90
years of innovation and leadership in diabetes care. This heritage
has given us experience and capabilities that also enable us to help
people defeat other serious chronic conditions: haemophilia, growth
disorders and obesity. Headquartered in Denmark, Novo Nordisk employs
approximately 40,300 people in 75 countries and markets its products
in more than 180 countries. For more information, visit
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Further information

Media: Katrine Sperling +45 4442 6718
krsp@novonordisk.com

Åsa Josefsson +45 3079 7708 aajf@novonordisk.com

Investors: Peter Hugreffe Ankersen +45 3075 9085
phak@novonordisk.com

Daniel Bohsen +45 3079 6376 dabo@novonordisk.com

Melanie Raouzeos +45 3075 3479 mrz@novonordisk.com

Kasper Veje +45 3079 8519 kpvj@novonordisk.com

Frank Daniel Mersebach (US) +1 609 235 8567 fdni@novonordisk.com

_______________________

References

1. Brod M, Pfeiffer KM, Barnett AH, et al. Patient/physicians inertia
in insulin intensification for patients with uncontrolled type 2
diabetes using basal insulin. Poster presentation (1081-P) at the
International Diabetes Federation (IDF) World Diabetes Congress, 1
December 2015.
2. Brod M, Pfeiffer KM, Barnett AH, et al. Perceptions of control
among type 2 diabetes patients treated with basal insulin. Poster
presentation (0742-P) at the International Diabetes Federation
(IDF) World Diabetes Congress, 1 December 2015.
3. Brod M, Pfeiffer KM, Barnett AH, et al. Perceptions of diabetes
control among physicians and patients with uncontrolled type 2
diabetes using basal insulin. Poster presentation (0741-P) at the
International Diabetes Federation (IDF) World Diabetes Congress, 1
December 2015.

ots Originaltext: Novo Nordisk A/S
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