Acta Diabetologica

, Volume 49, Issue 6, pp 429–433

Management of newly diagnosed patients with type 2 diabetes: what are the attitudes of physicians? A SUBITO!AMD survey on the early diabetes treatment in Italy

  • Concetta Suraci
  • Franca Mulas
  • Maria Chiara Rossi
  • Sandro Gentile
  • Carlo Bruno Giorda
Original Article

DOI: 10.1007/s00592-012-0374-5

Cite this article as:
Suraci, C., Mulas, F., Rossi, M.C. et al. Acta Diabetol (2012) 49: 429. doi:10.1007/s00592-012-0374-5

Abstract

Early intensive therapy in type 2 diabetes can prevent complications. Nevertheless, metabolic control is often sub-optimal in newly diagnosed patients. This web-based survey aimed to evaluate opinions of physicians about treatment, priorities, and barriers in the care of patients first referred to diabetes clinics. Data on physician attitudes toward therapeutic preferences for two clinical case models (same clinical profile, except HbA1c levels of 8.6 and 7.3% at the first access, respectively) were collected. Participants were asked to rank from 1 (most important) to 6 (least important) a list of priorities and barriers associated with the care of new patients. Overall, 593 physicians participated. In both case models, metformin and education were primary options, although their combination with other classes of drugs varied substantially. Main priorities were “to teach the patient how to cope with the disease” and “to achieve HbA1c target”; main barriers were “lack of time” and “long waiting list”. At multivariate analyses, physicians from the South of Italy had a twofold higher likelihood to attribute a rank 1–2 to organizational barriers than those operating in the North (South vs. North: OR: 2.4; 95% CI 1.4–4.1; Center vs. North: OR: 2.4; 95% CI 0.9–3.2). In the absence of a widely accepted evidence-based therapeutic algorithm driving the therapeutic choices according to the patient characteristics, prescriptions vary according to physician preferences. Education is perceived as a key-strategy, but organizational barriers and geographic disparities are an obstacle. These findings can drive new strategies to reduce clinical inertia, attitudes variability, and geographic disparities.

Keywords

Physician attitudesType 2 diabetesRecent diagnosisTherapeutic optionsPriorities of diabetes careGeographic variability

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Concetta Suraci
    • 1
  • Franca Mulas
    • 2
  • Maria Chiara Rossi
    • 3
  • Sandro Gentile
    • 4
  • Carlo Bruno Giorda
    • 5
  1. 1.Diabetes UnitSandro Pertini HospitalRomeItaly
  2. 2.Diabetes UnitSan Martino Hospital, ASL 5OristanoItaly
  3. 3.Department of Clinical Pharmacology and EpidemiologyConsorzio Mario Negri SudSanta Maria ImbaroItaly
  4. 4.Department of Geriatrics and Metabolic DiseaseSecond University of NaplesNaplesItaly
  5. 5.Diabetes and Metabolism UnitASL TO5ChieriItaly