Patients' Perspectives on Personalized Glycemic Targets for Coronary Artery Disease Prevention Based on the...

Recent research reported that people with type 2 diabetes (T2D) and the haptoglobin (Hp) 2-2 phenotype had reduced coronary artery disease risk with aggressive glycemic targets. Those without the Hp2-2 phenotype did not have this reduction and actually faced increased mortality risk, indicating that using the Hp phenotype test to personalize glycemic targets may be warranted. We aimed to explore the perspectives of individuals with T2D on personalized glycemic targets based on the Hp phenotype test.

In this qualitative descriptive study, we conducted semi-structured interviews that included 2 hypothetical scenarios about the Hp phenotype test with 25 Canadian adults with T2D between July and December 2024. Participants were purposively sampled, and interviews lasted 20-85 minutes. Inductive thematic analysis identified themes.

We identified 6 themes, as follows: (i) the Hp phenotype test could provide helpful new information; (ii) the test would not be inconvenient; (iii) test uptake would depend on characteristics of the healthcare provider and the accessibility of healthcare services; (iv) participants have fear that aggressive glycemic targets in the Hp2-2 phenotype may perpetuate stigma from healthcare providers and cause treatment burden; (v) motivation to use knowledge regarding the Hp2-2 phenotype to control blood sugar may be related to one's age, disease progression, and current glycemic target; and (vi) participants have uncertainty in how to use the information that they do not have the Hp2-2 phenotype in managing their T2D.

People with T2D were receptive to the concept of the Hp phenotype test and described potential barriers that would need mitigation to optimize clinical utility of the test.