According to new data from a study presented at the 76th American Diabetes Association Scientific Sessions in New Orleans, how healthcare professionals and people with diabetes communicate – as well as the perceived quality of the personal relationship between the parties – directly impacts knowledge of the disease by patients, distress related to living with diabetes, important care activities, such as frequency of self-monitoring blood glucose, and insulin adherence.
“We know from many studies that the majority of patients with type 2 diabetes using insulin are not achieving glycemic control,” said Seoyoung C. Kim, MD, associate physician at Brigham and Women’s Hospital, assistant professor of medicine at Harvard Medical School and lead investigator, in a statement. “While the data from MOSA1c confirms these findings, more concerning is that despite less than one-third of patients achieving glycemic control in this two-year observational study, only about 40% of patients with sub-optimal control added additional diabetes medication.”
Data from over 4,200 patients in 18 countries were monitored in a non-interventional manner for two years across North and Latin America, Europe, Asia, and the Middle East. Other findings included:
- Improvement in the patient-healthcare provider relationship was associated with a lower level of diabetes-related distress, higher diabetes knowledge scores, positive attitudes towards self-care, such as frequency of self-monitoring blood glucose, and higher self-reported adherence to the prescribed treatment.
- Patients who were younger, more highly educated and living in Asia were found to be more likely to have their insulin therapy progressed.
- Younger age, higher baseline A1C level and use of NPH insulin were significantly associated with a higher A1C level at the end of the study, adjusted for adherence.
The results could be an important step forward in helping the diabetes community understand insulin progression to help healthcare providers determine the right therapies at the right times for each patient. Given the complexities of available therapies across the globe, this should be an increasing area of research focus to help address this overwhelming public health issue. As a result of these findings, Lilly will be reaching out to diabetes experts from all regions included in the study in the coming months in order to gain a broad cross-cultural perspective on how best to explore the wealth of information from MOSA1c.
“In addition,” Kim added, “because the relationship between patients and healthcare professionals may have an effect on the amount of distress patients feel and, in some cases, the level of A1C, we recognize that how we communicate to patients and how patients receive that communication really matters.”
The study was funded by Eli Lilly and Company. Six abstracts from the Multinational Observational Insulin Progression (MOSA1c) study, which was led by Harvard-affiliated Brigham and Women’s Hospital, are being presented at the sessions.
About MOSA1c
MOSA1c is a large, comprehensive study which examined associations between patients’ backgrounds/behaviors, healthcare settings, healthcare provider relationships, and treatment outcomes for type 2 diabetes in a long-term prospective manner and followed more than 4,000 adults and 220 healthcare providers in 18 countries around the world. More than half of the people studied were in emerging markets, where the need is great and data has been limited. Ages ranged from 20-79 (50 percent male) with a wide range of socioeconomic status, including education levels, employment and insurance type. The study not only provides breadth that helps reveal patterns of treatment on a global scale, but also depth into the lives of the participants that can make the data truly meaningful.
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