Primary Care Diabetes Europe Issues Call to Action Against ClinicalInertia in the Treatment of Type-2 Diabetes

Ekeren, Belgium (ots/PRNewswire) – Research identifies lack of
primary care physician adherence to treatment guidelines among the
challenges to optimal care for patients with type-2 diabetes

Primary Care Diabetes Europe (PCDE) today issued a call to action
challenging primary care physicians and other healthcare providers to
escalate treatment of type-2 diabetes (T2D). This includes
encouraging the use of innovative and second- or third-line medicines
earlier in disease management of T2D, optimising the potential to
impact the disease. PCDE researchers also echo mounting scientific
evidence that suboptimal management of T2D can increase the risk of
common interrelated cardiovascular (CV) and renal comorbidities,
further undermining patient care.

Dr. Frances Xavier Cos, Chairman of PCDE, said: „Globally, one in 11
adults has diabetes[i] and delays in treatment can lead to an
increase in comorbidities[ii] including heart failure, an early and
frequent complication of diabetes that is associated with
hospitalisations resulting in a considerable societal and economic
burden.[iii] The early use of innovative treatments in type-2
diabetes is critical in helping people successfully manage their
diabetes and the interrelated CV and renal risks, ultimately helping
improve outcomes.[iv] Professional guidelines increasingly identify
how and when these treatments can optimally be used, and primary care
doctors in particular should be aware of the value of timely
escalation of treatment as they are the front lines of care for
patients with type-2 diabetes.“

The call to action is supported by recent research conducted by PCDE
to identify causes of widespread clinical inertia among physicians,
or the failure to establish appropriate targets and escalate
treatment to achieve each patient’s individual treatment goals.
High-level results from this research find a lack of adherence to
clinical guidelines on appropriate use of these therapies, as well as
other causes, including lack of familiarity with treatment options,
availability and cost as key drivers of clinical inertia.* Full
findings from the research, which was commissioned by AstraZeneca and
conducted in partnership with PCDE, along with detailed PCDE
recommendations, will be published in 2019 in Primary Care Diabetes.

These research findings and the PCDE call to action are especially
timely following the recent American Diabetes Association (ADA) and
the European Association for the Study of Diabetes (EASD) consensus
statement that addresses clinical inertia. The statement supports a
more patient-centric and integrated approach to the management of
diabetes and related CV and renal conditions, including lifestyle
interventions and earlier use of medicines with proven CV and renal
benefits. The ADA/EASD statement also supports treatment guidelines
that are informed by the latest research on early use of these
multi-functional medicines.

Dr. Danilo Verge, Vice President, Cardiovascular, Renal & Metabolism,
Global Medical Affairs, AstraZeneca, commented: „As a member of the
Early Action in Diabetes coalition, AstraZeneca supports Primary Care
Diabetes Europe as it contributes to our growing understanding of the
importance of early treatment of type-2 diabetes, cardiovascular and
renal disease in an integrated and proactive way. We are also working
with researchers on an economic impact study to understand the full
value to patients and our health systems when these diseases are
managed together. The need is clear on many levels and we stand with
Primary Care Diabetes Europe in urging a united, patient-centric
response.“

To learn more about the Primary Care Diabetes Europe call to action
and type-2 diabetes, visit https://www.pcdeurope.org/news/.

*PCDE conducted two separate quantitative and qualitative studies
involving perceptions and treatment practices among primary care
physicians in the United Kingdom, Spain, Italy, Germany, Poland,
Belgium, Denmark, Netherlands, Portugal, Romania, Spain, Sweden and
Switzerland. Findings indicate that, while first line treatment is
generally administered in adherence with guidelines, many primary
care physicians see those guidelines as less prescriptive or reliable
than personal clinical experience and the opinion of colleagues when
it comes to the use of other medicines.

NOTES TO EDITORS

About Diabetes

In 2017, 4 million patients died globally as a result of diabetes and
its complications.[v] Nearly 650 million people will have diabetes by
2040, and the cost of treating the disease just in adults aged 20-79
years will be $802 billion.[vi]

Delays in treatment can lead to suboptimal glycaemic control, poor
management of the disease and an increase in comorbidities.[vii]
Poorly controlled diabetes can increase the risk of cardiovascular
disease, blindness, kidney failure, amputations and premature
death.[viii]

About Primary Care Diabetes Europe (PCDE)

Primary Care Diabetes Europe (PCDE) exists to provide a focal point
for primary care clinicians and their patients. Its purpose is to
promote high standards of care for people living with diabetes
throughout Europe. Emphasis is placed on incorporating evidence based
medicine into daily practice as well as promoting diabetes education
and research in primary care.

Through successful activities and a leadership position in the field,
PCDE has an interface role between primary and secondary diabetes
care organizations regarding research, education, clinical practice
and health care governance aiming for a better quality of diabetes
care in the community.

About Early Action in Diabetes

Early Action in Diabetes (EAiD) is an international coalition of
clinicians, policymakers and other diabetes experts from more than 35
countries who are committed to radically transforming the world’s
approach to type-2 diabetes and its complications. This multi-year
initiative works to translate evidence into practical policies for
strengthening prevention, early detection, early control and early
access to the right interventions with the goal of improving patient
outcomes and the impact of these diseases on healthcare systems and
national economies.

Contact

Harry Wade, Ruder Finn, wadeh@ruderfinn.com, +1-917-4829057

i AstraZeneca (2017) The Berlin Declaration – A collective ambition
for policy change to drive early action in type 2 diabetes.

ii Khunti, K. et al. (2018) Therapeutic inertia in the treatment of
hyperglycaemia in patients with type 2 diabetes: A systematic review,
Diabetes, Obesity and Metabolism, 20:427-437.

iii International Diabetes Federation, IDF Diabetes Atlas, Eighth
Edition Update, 2017; Shah AD, Langenberg C, Rapsomaniki E, et al.
Type 2 diabetes and incidence of cardiovascular diseases: a cohort
study in 1·9 million people. Lancet Diabetes Endocrinol.
2015;3:105-113; Faden, et al. The increasing detection of
asymptomatic left ventricular dysfunction in patients with type 2
diabetes mellitus without overt cardiac disease: Data from the
SHORTWAVE study. Diabetes Res Clin Pract. 2013;101(3):309-16; Low
Wang, Cecilia C. et al. „Atherosclerotic Cardiovascular Disease and
Heart Failure in Type 2 Diabetes – Mechanisms, Management, and
Clinical Considerations.“ Circulation 133.24 (2016): 2459-2502. PMC.
Web. 19 Sept. 2018; Heidenreich, Paul A. et al. „Forecasting the
Impact of Heart Failure in the United States: A Policy Statement From
the American Heart Association.“ Circulation. Heart failure 6.3
(2013): 606-619. PMC. Web. 19 Sept. 2018; Nichols GA, Brown JB: The
impact of cardiovascular disease on medical care costs in subjects
with and without type 2 diabetes. Diabetes Care 25:482-486, 2002;
Nichols, et al. The incidence of congestive heart failure in type 2
diabetes. Diabetes Care, Volume 27, Number 8, Aug. 2004:
http://care.diabetesjournals.org/content/27/8/1879 .

iv Supporting earlier action in the treatment of Type 2 Diabetes – a
call to action; source cited: International Diabetes Federation, IDF
Diabetes Atlas, Seventh Edition, 2015.

v International Diabetes Federation, IDF Diabetes Atlas, Eighth
Edition, 2017.

vi International Diabetes Federation, IDF Diabetes Atlas, Seventh
Edition, 2015.

vii Khunti, K. et al. (2018) Therapeutic inertia in the treatment of
hyperglycaemia in patients with type 2 diabetes: A systematic review,
Diabetes, Obesity and Metabolism, 20:427-437.

viii International Diabetes Federation and International Working
Group on the Diabetic Foot, Diabetes. Available at:
http://www.idf.org/webdata/docs/background_info_NA.pdf .

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