PMID- 22700283
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20211021
IS  - 1869-6961 (Electronic)
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Linking)
VI  - 3
IP  - 1
DP  - 2012 Nov
TI  - Physician reasons for nonpharmacologic treatment of hyperglycemia in older 
      patients newly diagnosed with type 2 diabetes mellitus.
PG  - 5
LID - 10.1007/s13300-012-0005-8 [doi]
LID - 5
AB  - INTRODUCTION: To identify reasons why primary care physicians (PCPs) do not treat 
      older patients newly diagnosed with type 2 diabetes mellitus (T2DM) with 
      antihyperglycemic agents following diagnosis. METHODS: US PCPs were surveyed via 
      the internet regarding their reasons for not treating patients aged >65 years 
      diagnosed with T2DM and had not yet initiated antihyperglycemic therapy for 
      >/=6 months after diagnosis. PCPs were requested to provide relevant clinical 
      information for untreated older patients and select applicable reasons for not 
      initiating treatment from a list of 35 possibilities, grouped into five 
      categories. RESULTS: A total of 508 PCPs completed the online survey and provided 
      complete clinical data for 770 patients. The reasons provided by the first-ranked 
      physician for not initiating antihyperglycemic therapy were related to diet and 
      exercise (57.5%); mild hyperglycemia (23.8%); patient's concerns (13.4%); 
      concerns about antihyperglycemic agents (3.0%); and comorbidities and 
      polypharmacy (2.3%). The "diet and exercise" category was the most common 
      first-ranked non-treatment reason, regardless of recent hemoglobin A(1c) 
      (HbA(1c)) stratum. Reasons within the "patient's concerns," "concerns related to 
      antihyperglycemic agents," and "comorbidities and polypharmacy" categories tended 
      to be selected more often as first-ranked reasons by physicians for patients with 
      higher HbA(1c) values. Of the 158 patients whose physicians planned to initiate 
      antihyperglycemic therapy within the next month, 54.4% already had a most recent 
      HbA(1c) value above their physician-stated threshold for treatment initiation. 
      CONCLUSION: In the PCPs studied, there was a tendency to select appropriate 
      reasons for non-treatment with antihyperglycemic agents given their patients' 
      glycemic status. However, there was inertia related to the initiation of 
      pharmacological therapy in some older patients with newly diagnosed T2DM. 
      Important factors included physicians' perceptions of "mild" hyperglycemia and 
      the HbA(1c) threshold for using antihyperglycemic agents.
FAU - Marrett, Elizabeth
AU  - Marrett E
AD  - Global Health Outcomes, WS2E85, 1 Merck Drive, Whitehouse Station, NJ, 08889, 
      USA, elizabeth.marrett@merck.com.
FAU - Zhang, Qiaoyi
AU  - Zhang Q
FAU - Kanitscheider, Claudia
AU  - Kanitscheider C
FAU - Davies, Michael J
AU  - Davies MJ
FAU - Radican, Larry
AU  - Radican L
FAU - Feinglos, Mark N
AU  - Feinglos MN
LA  - eng
PT  - Journal Article
DEP - 20120615
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC3508110
EDAT- 2012/06/16 06:00
MHDA- 2012/06/16 06:01
PMCR- 2012/06/15
CRDT- 2012/06/16 06:00
PHST- 2012/04/05 00:00 [received]
PHST- 2012/06/16 06:00 [entrez]
PHST- 2012/06/16 06:00 [pubmed]
PHST- 2012/06/16 06:01 [medline]
PHST- 2012/06/15 00:00 [pmc-release]
AID - 5 [pii]
AID - 10.1007/s13300-012-0005-8 [doi]
PST - ppublish
SO  - Diabetes Ther. 2012 Nov;3(1):5. doi: 10.1007/s13300-012-0005-8. Epub 2012 Jun 15.