RESUMO
OBJECTIVE: Understanding patients' and physicians' perceptions of type 2 diabetes mellitus (T2DM) management and treatment has important implications for diabetes care, allowing the identification of clinical practice issues that could be improved, leading to patients' better understanding of the illness and, consequently, healthier self-management behaviors. The objective of this study was to identify differences between physicians' and T2DM patients' perceptions related to health status, patient-reported outcomes assessments, and T2DM management and treatment, in routine clinical practice in Spain. METHODS: This was an observational, cross-sectional study including 1,012 T2DM patients and 974 physicians from 47 and 52 Spanish provinces, respectively. An electronic structured self-administered questionnaire containing 17 questions was designed aiming to address both physicians' and patient's perceptions on overall T2DM health status and patient-reported outcomes. RESULTS: T2DM patients perceived a worse health status (40% reported having a "good" and 38% a "neither good nor bad" health status) compared with physicians' perceptions (77% thought patients had a "good" health status). Most patients answered being "satisfied" or "neither satisfied nor unsatisfied" with the given information, while physicians considered that patients were "satisfied" or "very satisfied" with the information for self-monitoring blood glucose and treatment administration. Fifty-seven percent of patients reported that medical recommendations were "important", while 58% of physicians considered it as "very important". Fifty-three percent of patients perceived that their current T2DM treatment suited their preferences "quite a lot", and this was lower than the proportion of physicians (69%) that believed this for their patients. Additionally, a lower percentage of patients (53%) than physicians (79%) believed that their treatment improved their health-related quality of life "quite a lot". All differences between patients and physicians were statistically significant (P<0.001). CONCLUSION: Patients and physicians demonstrate different views concerning all questions related to T2DM health status and diabetes management and treatment (information, recommendations, satisfaction, and preferences).
RESUMO
La importancia de la detección precoz de la nefropatía diabética radica en que es un marcador de riesgo cardiovascular y nos indica la existencia de una alteración vascular que se asocia a un aumento del riesgo de padecer un evento cardiovascular, tanto en la diabetes Mellitus tipo 1 (DM 1) como en la tipo 2 (DM 2).La microalbuminuria es un factor de riesgo para la mortalidad total, cardiovascular y coronaria, en los pacientes con DM 1.La mortalidad total se encuentra aumentada en pacientes con DM 2 y microalbúmina, con un RR del 1.8 y se relaciona con niveles de microalbúmina incluso por debajo del rango considerado como normal (20mg/minuto y/o 30mg/día). Por ello, la definición de microalbúmina debe ser revisada en los pacientes con DM 2.Se necesitan más trabajos que confirmen el poder predictivo de la microalbuminuria sobre la enfermedad cardiovascular y coronaria(AU)
The importance of the early detection of diabetic nephropathy is because it is a cardiovascular risk marker and it indicates the existence of vascular changes associated to an increase risk of having a cardiovascular event in diabetes mellitus type 1 (DM 1), as well as in type 2 (DM 2).Microalbuminuria is a risk factor for overall cardiovascular and coronary mortality in the patients with DM 1.Total mortality is increased in patients with DM 2 and microalbuminuria with a RR of 1.8, and it is related to microalbuminuria levels even below the considered normal range (20mg/min and/or 30mg/day). For this reason, the definition of microalbuminuria must be reviewed in the patients with DM 2.More studies are needed to confirm the predictive power of microalbuminuria in cardiovascular and coronary disease(AU)