The survey, which was conducted by a Global Task Force (GTF) on Glycaemic Control, a panel of 15 global experts in diabetes and endocrinology, in association with Novo Nordisk, questioned nearly 1,400 HCPs and over 1,000 patients in eight countries (UK, Poland, Turkey, Canada, Russia, Sweden, India and China). It aimed to evaluate their awareness, attitudes and behaviours towards the management of type 2 diabetes, and to identify key barriers to good glycaemic control. The survey specifically investigated awareness and use of the HbA1c test, which is the only method of measuring long-term blood sugar levels (also referred to as glycosylated haemoglobin), and results demonstrate a clear gap between guideline recommendations on glucose monitoring and clinical reality.

“Achieving good glycaemic control is vital for people with type 2 diabetes, but this new survey shows that patient awareness and understanding of HbA1c testing is limited, and its value in the wider management of the condition is underestimated by HCPs,” commented Dr Kerstin Berntorp, member of the GTF on Glycaemic Control, Department of Endocrinology, Malmö University Hospital, Sweden. “Each 1% reduction in HbA1c decreases the risk of damage to the retina, kidneys and nerve function by 37%, and the risk of diabetes-related death by 20%. These figures demonstrate the importance of controlling blood glucose levels and they should not be overlooked.”

Despite the fact that the HbA1c test is recognised as part of a series of tests needed for optimal treatment of type 2 diabetes, and current guidelines from the International Diabetes Federation (IDF) recommend that testing takes place every two to six months if clinicians are to effectively relate individual blood glucose control to risk of complication development,1,2 the survey shows that it is used far too infrequently.

Furthermore, communication about the importance of the test is inadequate, and patient awareness and understanding of HbA1c is low. These factors are likely to contribute greatly to the suboptimal glycaemic control observed in many countries3–7, including those that participated in the survey. In addition, short and infrequent consultations often due to stretched healthcare systems, as well as treatment adherence issues with regard to complex regimens and negative preconceptions about insulin among patients, were identified as key barriers to improving glycaemic control.

“This new data is very important for the future management of type 2 diabetes,” said Professor Eric Kilpatrick, chairman of the GTF on Glycaemic Control, Hull Royal Infirmary, UK. “Not only is the problem of poor glycaemic control very real in most countries, and becoming a major medical and economic challenge worldwide, it is linked to issues that we can change. Many patients with diabetes are not achieving the HbA1c level of 6.5%, the target level recommended by the IDF if the risk of developing complications is to be minimised. The GTF is working to identify practical solutions that will motivate and enable physicians and their patients to test HbA1c more regularly. We believe that education is key, and are currently developing management recommendations, and will be working to implement these with full guidance for clinical practice in 2008.”

Further information:
Katrine Sperling
+45 3079 6718
krsp@novonordisk.com