Differences in Patient Perspectives of Type 2 Diabetes Management and Care by Current A1C
Authors: BROD MERYL , TOMASZEWSKI KENNETH J. , ALLEN AMY , KRUGER DAVIDA F. , HEILE MICHAEL K. , MOCARSKI MICHELLE , SCHIFFMAN ALISA , HANDELSMAN YEHUDA 
Published: June 2018

Background: This analysis aimed to understand differences in patient perspectives of their type 2 diabetes (T2DM) management and whether perspectives differed by patients’ current A1C.
Methods: A cross-sectional, U.S. based web-survey was conducted among 618 adults with T2DM using basal insulin with or without oral antidiabetic medication which assessed perceptions, attitudes and behaviors associated with T2DM management. A1c levels were self-reported by patients as last communicated by their HCP, and confirmed with their HCP if necessary.
Results: Patients with an A1c of ≥8% (n=193) were less likely than those with an A1c of 7-7.99% (n=194) or an A1c of &lt;7% (n=231) to agree that they know how to control their T2DM (64% vs. 77% and 87%, p&lt;0.05) and were less motivated to do so (59% vs. 74% and 80%, p&lt;0.05). They were also less likely to report maintaining a healthy diet, being able to achieve their desired weight, and taking their T2DM medications as recommended. Patients with A1c ≥8% were also less likely to agree they have a good relationship with their HCP, kept their regularly scheduled appointments, and to find conversations with their HCP about T2DM control to be helpful. They were particularly less likely to feel their HCP could motivate them (63% vs. 84% and 81%, A1c 7-7.99% and A1c &lt;7% respectively, p&lt;0.05) and understood their life and challenges with T2DM (60% vs. 80% and 83%, p&lt;0.05).
Conclusions: In addition to differing perceptions of their ability to control their T2DM and struggling with adherence behaviors, patients with A1c ≥8% appear to have difficulty relating with their HCP. Although the directionality of the poorer HCP relationships and perceptions of control is unclear, better understanding the challenges faced by patients in controlling their T2DM may aid the development of successful strategies to help patients struggling with control.

Disclosure
M. Brod: Consultant; Self; Novo Nordisk A/S. K.J. Tomaszewski: Research Support; Self; Novo Nordisk Inc. A. Allen: Research Support; Self; Novo Nordisk Inc. D.F. Kruger: Research Support; Self; Dexcom, Inc.. Speaker's Bureau; Self; Dexcom, Inc.. Stock/Shareholder; Self; Dexcom, Inc.. Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Eli Lilly and Company, Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Intarcia Therapeutics, Inc., Abbott. Research Support; Self; Sanofi. Consultant; Self; Sanofi. Research Support; Self; JAEB Center For Health Research. Consultant; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; Hygieia, Lexicon Pharmaceuticals, Inc., National Institute of Diabetes and Digestive and Kidney Diseases. Speaker's Bureau; Self; Valeritas, Inc., Insulet Corporation. Consultant; Self; Insulet Corporation. Research Support; Self; Insulet Corporation. Consultant; Self; Merck & Co., Inc. M.K. Heile: Advisory Panel; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc., Insulet Corporation. Advisory Panel; Self; Dexcom, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Roche Diagnostics Corporation. M. Mocarski: Employee; Self; Novo Nordisk Inc.. Stock/Shareholder; Self; Novo Nordisk A/S. A. Schiffman: Employee; Self; Novo Nordisk Inc. Y. Handelsman: Consultant; Self; Amarin Corporation. Speaker's Bureau; Self; Amarin Corporation. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Amgen Inc.. Research Support; Self; Amgen Inc.. Speaker's Bureau; Self; Amgen Inc.. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Gan & Lee Pharmaceuticals. Consultant; Self; Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Lexicon Pharmaceuticals, Inc.. Consultant; Self; Merck & Co., Inc.. Research Support; Self; Merck & Co., Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc., Regeneron Pharmaceuticals, Inc.. Consultant; Self; Sanofi. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi.