scholarly journals Psychological Resistance for Insulin Therapy Among Patients with type 2 Diabetes Mellitus: a Cross Sectional Survey

2015 ◽  
Vol 20 (1) ◽  
pp. 2
Author(s):  
S. Thillainathan ◽  
N. Pratheep ◽  
I.U.K. Marasinghe ◽  
K. Karunayokiny ◽  
K.P. Gunasinghe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Changes in hyperglycaemia-related testing for prediabetes and type 2 diabetes mellitus management: a prospective, cross-sectional survey of 16 years of general practice data from Australia

2021 ◽  
Author(s):  
Andrew Leigh ◽  
Jennifer Hunter ◽  
Christopher Harrison ◽  
Helena Britt ◽  
Eugen Molodysky
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cluster Sampling ◽  
Lifestyle Modifications ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Encounters ◽  
Annual Trends

Abstract BackgroundThe rising prevalence of prediabetes increases the population risk of type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular disease. Early identification by General Practitioners (GPs) provides opportunities for lifestyle modifications that can lower these risks.MethodsThis study examined 16 years of annual trends (2000/01-20015/16) in hyperglycaemia-related testing for patients in Australia aged 13 years or older with, or at risk of a diagnosis of T2DM. The Bettering the Evaluation and Care of Health (BEACH) study is a national cross-sectional survey, with a single-stage, cluster sampling design. Approximately 1,000 GPs were randomly selected annually (2000/01-20015/16) from across Australia, who each recorded details of 100 consecutive clinical encounters with consenting patients. Means and 95% confidence intervals were adjusted for intracluster correlation and GP characteristics.Results15,679 GPs recorded details of 1,387,190 clinical encounters with patients aged 13+ years. Prediabetes and T2DM were managed at 0.25% (95% CI: 0.24-0.27%) and 3.68% (95% CI: 3.62-3.73%) of encounters respectively. By the end of the study, annual management rates were 2.3 times higher for prediabetes and 1.5 times for T2DM management. The likelihood of ordering at least one hyperglycaemia-related test during prediabetes management occasion was twice the likelihood in management of T2DM. For prediabetes, glucose tolerance tests were most common but from 2014/15, requests for HbA1c tests began to increase. For T2DM, HbA1c tests were most common, and requests for one or more glucose tests gradually declined.ConclusionThe observed 16-year annual trends align with the rising incidence of prediabetes and T2DM. GPs appeared to be strongly influenced by changes to the national insurance scheme and clinical guidelines for hyperglycaemia-related pathology testing. However, some GPs may have been pre-empting policy changes as there was also evidence of ‘unendorsed’ testing, notably for prediabetes that warrants further investigation. The increasing management rates for prediabetes, coupled with higher rates of pathology requesting have substantial resource implication. Calls to lower the risk threshold for prediabetes screening therefore warrant an economic analysis. Ongoing, reliable, up-to-date data is needed to inform clinical practice guidelines and policy in Australia.

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