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Diabetes Experts Call for Early, Integrated Treatment Approach to Help Prevent Complications and Improve Patient Outcomes

Ridgefield, CT, March 11, 2010 — Results from a new online survey of more than 300 practicing endocrinologists and family medicine physicians¹ show that a large majority of physicians (83 percent)¹ indicated that using a team of specialists early in the course of type 2 diabetes (T2D) treatment can help prevent serious T2D-related complications.  However, more than nine out of 10 physicians (93 percent)¹ surveyed do not believe their peers are using this team approach. The online survey was supported by Boehringer Ingelheim Pharmaceuticals, Inc. and conducted by Sermo. 

Physicians surveyed identified cardiovascular disease, diabetic neuropathy (nerve pain) and diabetic nephropathy (kidney disease) as the most common complications experienced by their T2D patients.¹ Other serious complications cited include stroke, blindness and limb amputation.¹ Between 2002 and 2007, the cost of T2D-related complications to our healthcare system more than doubled from $24.6 billion to $58 billion.^2,3 The survey also measured prevalence of T2D-related complications, with more than 40 percent of physicians surveyed (44 percent) saying that over half of their T2D patients develop at least one complication.¹

“So many patients with type 2 diabetes suffer needlessly from serious and often deadly complications,” said Deborah S. Fillman, president of the American Association of Diabetes Educators and a member of the steering committee that developed the survey.  “As a public health director, I have seen firsthand what an enormous burden these complications can have not only on type 2 diabetes patients themselves, but also on the healthcare system."

An integrated treatment approach means utilizing a team of specialists such as a dietitian, diabetes educator, endocrinologist, cardiologist and nephrologist to help T2D patients manage all aspects of the complex condition.  While the approach has been used over the last decade in diabetes care centers across the country, its potential value to patients, in terms of increasing understanding of and preventing complications like heart attack and kidney failure, warrants further exploration.

Physicians surveyed confirmed the need for increased patient understanding of T2D-related complications.  For example, despite the fact that T2D is a leading cause of kidney disease and dialysis,⁴ 40 percent of physicians surveyed do not believe the majority of their newly-diagnosed patients know that T2D can lead to kidney disease.¹

“It’s concerning that so many newly-diagnosed patients are unaware that kidney problems are a common complication of type 2 diabetes,” said Dr. Mark Williams, clinical investigator and senior staff physician, Joslin Diabetes Center and a member of the steering committee.  “My patients often associate kidney damage with the need for dialysis, but they don’t realize that the damage starts early on.  Many people who are diagnosed with type 2 diabetes already have some degree of kidney impairment.”

Research shows that kidney impairment can also be an independent predictor of other T2D-related complications such as heart disease,⁵ which can account for up to 50 percent of all diabetes deaths.⁶ People with T2D are more than twice as likely to have a heart attack than those who don't have the condition.⁷

Additional Survey Findings

• Physicians surveyed report lack of motivation, lack of adherence to medication and inability to lose weight as the most common reasons their T2D patients are not effectively controlled.¹ Compliance with lifestyle modifications, compliance with medication and patient understanding are the top-reported obstacles to preventing complications.¹
• Seven out of 10 endocrinologists polled (71 percent)¹ have a diabetes educator in their practice; only three out of 10 family physicians (32 percent) have one.¹
• Half of physicians (52 percent)¹ say they monitor for all T2D-related complications equally.
• Family physicians polled are more likely than endocrinologists to refer to nephrologists when mild kidney impairment is detected (32 percent vs. 12 percent); endocrinologists tend to wait until kidney function has declined to “moderate.”¹
• Endocrinologists tend to be more enthusiastic than family practitioners about referring their T2D patients to healthcare specialists.  Nearly four of 10 (36 percent)¹ endocrinologists surveyed consider the integrated approach to be "extremely beneficial" while one in four (25 percent)¹ family medicine practitioners say the same.

“We hope that these survey findings serve as a call to action for the type 2 diabetes treatment community,” said Deborah S. Fillman.  “Now is the time to defy this type 2 diabetes epidemic and the common, and potentially preventable, complications that affect millions of patients.”

About the Steering Committee
Boehringer Ingelheim Pharmaceuticals, Inc. convened a multi-disciplinary steering committee to develop a survey and interpret its findings with the aim of educating and inspiring action among T2D patients who are at risk for serious complications. Following the completion of the survey, the committee is continuing to work closely with the diabetes care community to help patients better understand the impact of T2D-related complications and empower them to work more closely with their healthcare team to better manage all aspects of their T2D.

Steering committee members include:

• Deborah S. Fillman, MS, RD, LD, certified diabetes educator, president of the American Association of Diabetes Educators (AADE)
• Vivian Fonseca, MD, endocrinologist, Tulane University Medical Center
• Peter A. McCullough, MD, cardiologist, William Beaumont Hospital
• Mark Williams, MD, nephrologist, Joslin Diabetes Center

About the Survey
A total of 303 physicians (203 family medicine, 100 endocrinologists)¹ were polled online via Sermo in December 2009.  Physicians polled treated an average of 47 T2D¹ patients per week and have been practicing for an average of 19 years.¹

About Sermo
Sermo is the largest online physician community, where over 110,000 physicians¹ collaborate to improve patient care. Through a unique set of social media tools, Sermo provides access to its community for organizations that need fast, actionable physician insights.  Visit http://www.sermo.com to learn more.  

About Type 2 Diabetes
There are approximately 27 million Americans⁸ and 285 million⁸ people worldwide with diabetes.  Every ten seconds two people develop diabetes and one person dies from diabetes-related causes around the world.⁷ Diabetes is a chronic disease that occurs when the body either does not properly produce or use the hormone, insulin.⁷ Type 2 diabetes is the most common form, accounting for more than 90 percent of all cases in the developed world.⁶

About Boehringer Ingelheim Pharmaceuticals, Inc.
Boehringer Ingelheim Pharmaceuticals, Inc., based in Ridgefield, CT, is the largest U.S. subsidiary of Boehringer Ingelheim Corporation (Ridgefield, CT) and a member of the Boehringer Ingelheim group of companies.

The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 138 affiliates in 47 countries and approximately 41,300 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel products of high therapeutic value for human and veterinary medicine.

In 2008, Boehringer Ingelheim posted net sales of US $17 billion (11.6 billion euro) while spending approximately one-fifth of net sales in its largest business segment, Prescription Medicines, on research and development.

For more information, please visit  http://us.boehringer-ingelheim.com and follow us on Twitter at twitter.com/boehringerus.

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References

1. Sermo. Survey Analysis: Type 2 Diabetes Mellitus Treament. January 2010.
2. American Diabetes Association. Economic Costs of Diabetes in 2002. Diabetes Care, March 2003 vol. 26 no3. 917-93.
3. American Diabetes Association. Economic Costs of Diabetes in 2007. Diabetes Care, March 2008 vol. 31 no3. 596-615.10.
4. Centers for Disease Control. National Diabetes Fact Sheet-2007. Available at: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf. 8. Accessed on: March 1, 2010.
5. Borch-Johnsen K et al. Urinary albumin excretion. An independent predictor of ischemic heart disease. Arterioscler Thromb Vasc Biol 19(8): 1992-1997,1999
6. World Health Organization. Fact Sheet No. 312: What is Diabetes? Available at: http://www.who.int/mediacentre/factsheets/fs312/3. en/. Accessed on: March 1, 2010.
7. International Diabetes Federation. Diabetes Atlas. 3rd ed.  Brussels: International Diabetes Federation, 2006.
8. International Diabetes Federation. Diabetes Atlas. 4th ed. Brussels: International Diabetes Federation, 2009.

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