Patients’ And Physicians’ Perspectives On Glycemic Control Targets In Type 2 Diabetes: A Comparative Survey Study

Abstract

Optimal glycemic control is still fundamental to controlling Type 2 Diabetes mellitus, however, physicians' glycemic targets and patients' expectations are frequently different. The purpose of this study was to compare patients' and physicians' views of what constitutes appropriate glycemic control targets and investigate what factors influence those views.

The study was a cross-sectional comparative survey conducted from January to April 2025 with patients diagnosed with Type 2 Diabetes and physicians who manage diabetes care. Two hundred twenty (220) participants made up the sample: (N=150) represented patients diagnosed with Type 2 Diabetes and (N=70) represented physicians (endocrinologists or primary care providers). A structured questionnaire, consisting of three sections (demographics, perception of target glycemic level, and factors influencing treatment goals), was used to gather data. Glycemic targets were evaluated primarily as Hemoglobin A1c (HbA1c). The statistical analyses of the data were conducted using descriptive statistics, chi-square tests, and independent sample t-tests to compare between the two groups. A statistical significance level was set at a p-value of <0.05.

68.7% of physicians reported having a strict glycemic control goal of HbA1c of <7%, in accordance with international diabetes management guidelines, and only 41.3% of patients felt similarly. About 36.0% of patient felt HbA1c levels between 7 and 8% were acceptable, while only 18.6% of physicians felt the same way. In addition, 22.7% of patients indicated that they were unsure about the recommended HbA1c goal.

Physicians were significantly more likely to support individualized glycemic targets based upon age, commorbid conditions, and potential for developing hypoglycemia (p<0.003). A large number of patients stated that fear of hypoglycemia or medication side effects affected their willingness to attempt rigorous glycemic control, while 64.2% of physicians stated that the prevention of long-term complications guided their treatment goals.

The study highlighted a significant discrepancy between the clinician and patient glycemic control goals. There is clearly a need for improved shared decision making, education about the diabetes condition, and the development of individualized treatment plans for better adherence and ultimately, improved long-term diabetes outcomes.