open access publication

Article, 2023

Healthcare Professionals' Knowledge of and Attitudes Towards the Use of Time in Range in Diabetes Management: Online Survey Across Seven Countries

DIABETES THERAPY, ISSN 1869-6953, 1869-6953, Volume 14, 8, Pages 1399-1413, 10.1007/s13300-023-01429-x

Contributors

De Block, C. 0000-0002-0679-3203 (Corresponding author) [1] Cheng, A. Y. Y. [2] Christensen, Trine Brandt [3] [4] Patted, U. R. H. [5] Ginovker, Anna [6]

Affiliations

  1. [1] Univ Antwerp, Antwerp Univ Hosp, Fac Med & Hlth Sci, Dept Endocrinol Diabetol & Metab, Antwerp, Belgium
  2. [NORA names: Belgium; Europe, EU; OECD];
  3. [2] Univ Toronto, Trillium Hlth Partners & Unity Hlth, Toronto, ON, Canada
  4. [NORA names: Canada; America, North; OECD];
  5. [3] Ascendis Pharm, Copenhagen, Denmark
  6. [NORA names: Ascendis Pharma; Private Research; Denmark; Europe, EU; Nordic; OECD];
  7. [4] Novo Nord AS, Copenhagen, Denmark
  8. [NORA names: Novo Nordisk; Private Research; Denmark; Europe, EU; Nordic; OECD];
  9. [5] Novo Nordisk GBS, Bangalore, Karnataka, India
  10. [NORA names: India; Asia, South];

Abstract

IntroductionTime in range (TIR) is a metric of glycaemic target management derived from continuous glucose monitoring (CGM) data. This study aimed to understand knowledge of and attitudes towards use of TIR among healthcare professionals (HCPs), and gain insights into benefits and barriers to its use in clinical practice.MethodsAn online survey was disseminated across seven countries. Participants were sampled from online HCP panels and were aware of TIR (defined as amount of time in, below, and above target range). Participants were HCPs classified as specialists (SP), generalists (GP), or allied HCPs (AP; diabetes nurse specialists, diabetes educators, general nurses, nurse practitioners/physician assistants).ResultsRespondents included 741 SP, 671 GP and 307 AP. Most HCPs (approximately 90%) agreed TIR is likely/somewhat likely to become the standard of diabetes management. Perceived benefits of TIR included helping to optimise medication regimen (SP, 71%; GP, 73%; AP, 74%), giving HCPs the knowledge and insights to make informed clinical decisions (SP, 66%; GP, 61%; AP, 72%), and empowering people with diabetes with information to successfully manage their diabetes (SP, 69%; GP, 77%; AP, 78%). Barriers to wider adoption included limited CGM access (SP, 65%; GP, 74%; AP, 69%) and lack of HCP training/education (SP, 45%; GP, 59%; AP, 51%). Most participants considered integration of TIR into clinical guidelines, recognition of TIR by regulators as a primary clinical endpoint, and recognition of TIR by payers as a parameter for diabetes treatment evaluation as key factors for increased use.ConclusionsOverall, HCPs agreed on the benefits of using TIR for diabetes management. Besides raising awareness among HCPs and people with diabetes, more training and healthcare system updates are needed to facilitate increased TIR use. In addition, integration into clinical guidelines and recognition by regulators and payers are needed.

Keywords

Clinical practice, Continuous glucose monitoring, Diabetes management, Glycaemic management, Time in range

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