Boehringer Ingelheim (Canada) Ltd. Release: Diabetes Patients and GPs Don't Agree on Most Worrisome Complications of Condition

Published: Aug 28, 2012

National survey reveals disconnect between what Type 2 diabetes patients believe and what doctors are telling them

TORONTO, Aug. 28, 2012 /CNW/ - Warnings about the severity of some complications associated with Type 2 diabetes may not be getting through to Canada's diabetes patients, according to findings from a national survey.

While heart disease and declining kidney function top the list of Type 2 diabetes complications that general practitioners say they are most concerned about (96 per cent and 84 per cent respectively), blindness and amputation are patients' top worries (60 per cent and 50 per cent respectively). When asked which body part will be most impacted by Type 2 diabetes, patients selected feet and eyes ahead of major organs like the heart and kidneys.

"These statistics are quite concerning," says says Dr. Richard Tytus, family physician and associate clinical professor at McMaster University in Hamilton, Ontario, who contributed to the design of the survey. "Patients are underestimating the life-threatening impact of heart or kidney complications and focusing more on less fatal complications. The reality is that you won't need to worry about being blind if your heart stops beating or your kidneys shut down."

In Canada, almost three million people have diabetes, and 90 per cent of these have Type 2. Type 2 diabetes is a serious, chronic illness that can be difficult to manage because of its complexity. Fifty per cent of people with Type 1 and Type 2 diabetes have chronic kidney disease, and 67 per cent of patients with Type 2 diabetes have at least one specific risk factor for declining renal function. All individuals with chronic kidney disease should be considered at high risk for cardiovascular events.

Kidney Complications a Particular Concern for Physicians

According to the national survey, less than half of Type 2 diabetes patients (44 per cent) say they are worried about declining kidney function and 47 per cent don't even consider themselves to be at high risk of developing kidney disease because of their diabetes. Dr. Tytus notes that these statistics are particularly concerning, given that chronic kidney disease associated with diabetes is the leading cause of kidney failure in Canada.

"High blood glucose causes damage to the delicate blood vessels in the filters of the kidneys, and as the diabetes progresses, these filters can become so damaged that the kidneys fail," says Dr. Tytus. "Diabetes patients don't appear to be concerned about this, but they should be."

Nadine Valk, National Director of Programs and Public Policy with The Kidney Foundation of Canada, which also contributed to the survey design, agrees. "Many people with diabetes could have serious kidney damage without being aware of it. Signs of early kidney damage can develop in 50 per cent or more of people with diabetes. The challenge is that there are usually no specific symptoms of kidney disease until the damage is severe."

Patients Are Not Always Hearing What Physicians Tell Them

While almost eight in 10 (77 per cent) of family physicians surveyed say they have talked to their diabetes patients about kidney function, only half of patients (52 per cent) report having had these conversations with their physician. Additionally, 56 per cent of patients say that their physician has not told them that their kidney health is at risk from their Type 2 diabetes at all.

"We need to redouble our efforts to help our patients understand the complexity of diabetes and its impact on kidney function," says Dr. Tytus. "It's not a simple discussion to have, but an important one. We also need to find ways to simplify treatment, which can also be complex."

An additional challenge for physicians, he says, is that most anti-diabetic treatments have prescribing limitations due to the fact that they are passed through the kidneys. As kidney function declines, some patients may need to adjust the dose of their medication or stop taking it altogether, if it is cleared through the kidneys, to prevent accumulation of drug in their bodies. Many of the most commonly used oral medications that help control blood sugar levels are either not indicated for use in patients with compromised renal function, or must be adjusted carefully as a patient's renal function declines.

"Working closely with their physician, patients can optimize treatment outcomes and hopefully delay damage to their kidneys," says Ms. Valk. "It's important that diabetes patients follow a healthy lifestyle, have their urine, blood and blood pressure checked regularly, and ask their doctor about any new developments in the treatment of diabetes."

Additional Survey Findings
*Please see attached infographic for corresponding graphs and statistics for the following key findings:

  • Overall, physicians are much more concerned about the complications of Type 2 diabetes than patients.
  • British Columbia diabetes patients are the most likely to "get it right" by naming the same complications as the physicians as top concerns.
  • Patients in the Prairies, Ontario, Quebec, and Atlantic provinces are much more concerned about blindness as a complication of their disease than patients in British Columbia.
  • Patients in Atlantic Canada are more likely to be concerned about amputation as a complication of diabetes than most other provinces.
  • Patients in British Columbia and Ontario are much more concerned about heart disease as a complication of diabetes, than patients in all other provinces.
  • Erectile dysfunction as a complication of diabetes is more concerning to patients in the Prairies and Quebec than in British Columbia or Ontario.

About the National Survey
The national survey was conducted by Vision Critical in partnership with The Kidney Foundation of Canada, Boehringer Ingelheim (Canada) Ltd. and Eli Lilly Canada. The research was conducted online from December 20, 2011 to January 13, 2012. The sample included both Canadian GPs and adult diabetes sufferers. A total of 760 adult diabetes sufferers were recruited via the Angus Reid Forum, according to Statistics Canada's most current education, age, gender and region Census data to ensure a representative sample of the entire adult population of Canada. A total of 301 physicians were recruited to be representative of the regional distribution of GPs. Statistical testing has been conducted at the 95 per cent Confidence Level.

About the Kidney Foundation of Canada
The Kidney Foundation of Canada is the national volunteer organization committed to reducing the burden of kidney disease through funding and stimulating innovative research; providing education and support; promoting access to high quality healthcare; and increasing public awareness and commitment to advancing kidney health and organ donation.

SOURCE Boehringer Ingelheim (Canada) Ltd.

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