MONDAY, June 18 (HealthDay News) -- When it comes to selecting insulin or other drugs to treat type 2 diabetes, physicians often rely on clinical factors and patient behavior, rather than quantitative factors, such as a patient's weight or age, according to study findings published in the June issue of Diabetes Care. Generalists are more likely than specialists to consider a patient's fear of using insulin or desire to avoid the drug when it comes to making treatment decisions.
Richard W. Grant, M.D., of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues surveyed 886 members of the Society of General Internal Medicine (generalists) or the American Diabetes Association (specialists). They asked the physicians to rate the importance of 15 factors affecting medication choices during three management stages: initiation, use of second-line oral agents, and insulin.
The researchers found that physicians took into account the overall assessment of the patient's health/comorbidity, A1C level and patient's adherence behavior, but did not place as great an emphasis on expert guidelines/hospital algorithms or patient age when making decisions. They also found that qualitative factors, such as the patient's overall health and motivation, were ranked more highly than quantitative factors, such as the patient's weight and A1C level.
"Achieving more uniform and cost-effective hyperglycemic medication management may require both better evidence in favor of specific treatment strategies and further insight into why physicians make individual exceptions from standard care," the authors conclude.
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