Nonachievement of Glycemic Target—Results from the International Diabetes Management Practices Study (IDMPS)
Authors: ASCHNER PABLO , GAGLIARDINO JUAN J. , ILKOVA HASAN M. , LAVALLE-GONZALEZ FERNANDO J. , RAMACHANDRAN AMBADY , KADDAHA GHAIDA , MBANYA JEAN CLAUDE , SHESTAKOVA MARINA V. , CHANTELOT JEAN-MARC , CHAN JULIANA C. 
Published: June 2018

Patient knowledge and self-management are important factors in attaining glycemic goals. The IDMPS is an observational survey on the management and patterns of care of people with type 1 (T1D) and type 2 (T2D) diabetes. People were enrolled from 24 countries in the Middle East including Pakistan, South Asia (India, Bangladesh), Eurasia (Russia, Ukraine) and Africa in 2016-17. Physicians reported the challenges their patients face in achieving glycemic goals.
In people with T1D (N=2000), only 28.3% attained HbA1c levels targeted by their physician (HbA1c &lt;7% and HbA1c 7-7.5% [targeted in 45.3% and 44.6% of people, respectively]). Fear of hypoglycemia, lack of insulin titration, and cost were the most common reasons for not attaining glycemic goals (Table 1).
Only 31.3% and 27.6% people with T2D (N=2596) treated with insulin alone or insulin plus oral glucose-lowering drugs (OGLDs), respectively, achieved the HbA1c level targeted by their physician. The most common reasons for not attaining glycemic goals were lack of insulin titration, lack of experience with insulin dosing, and lack of education.
Discontinuation of insulin, lack of support, and insufficient knowledge are major barriers to glycemic control in T1D and T2D. Factors related to hypoglycemia are more common in T1D. These data highlight the need for appropriate education strategies and sustained access to therapy.

Disclosure
P. Aschner: Other Relationship; Self; Sanofi. J.J. Gagliardino: Other Relationship; Self; Sanofi. H.M. Ilkova: Advisory Panel; Self; Abbott, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S, Boehringer Ingelheim GmbH, Servier, Merck Sharp & Dohme Corp.. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Medtronic, Roche Diabetes Care Health and Digital Solutions, Bilim İlac. F.J. Lavalle-Gonzalez: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; AstraZeneca. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. A. Ramachandran: None. G. Kaddaha: Other Relationship; Self; Sanofi. J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier. M.V. Shestakova: None. J. Chantelot: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.