Diabetes injectable therapy: type 2 diabetes management in Danish practice

Area of Science:

• Endocrinology
• Primary Care Medicine
• Diabetes Management

Background:

• General Practitioners (GPs) manage most type 2 diabetes (T2D) care in Denmark.
• Initiating injectable therapies is crucial for effective T2D management but presents challenges.

Purpose of the Study:

• To identify barriers faced by GPs in initiating injectable therapies for T2D.
• To understand reasons for GP referral of T2D patients to specialists.

Main Methods:

• A web interview study was conducted with 85 GPs and 30 specialists experienced in T2D.
• The study explored GPs' comfort levels with initiating first- and second-line injectable therapies.

Main Results:

• GPs expressed greater comfort initiating first-line injectables (GLP-1 RA or basal insulin) than second-line.
• Key barriers included treatment complexity and managing patients with difficult glycemic control or comorbidities.
• GPs preferred referring complex cases to specialists.

Conclusions:

• Complexity of injectable therapies and patient profiles are significant barriers for GPs in T2D management.
• Treatments with low hypoglycemia risk, improved glycemic control, and ease of use could enhance GP confidence.
• Simplifying injectable therapies may facilitate their initiation in primary care settings.