Novo NordiskMore than one in three diabetes patients skip doses or fail to take their insulin as prescribed, stating that they have done so on average three times in the last month, and 77% of physicians estimate that in reality this number could be as high as six doses*, according to the Global Attitudes of Patients and Physicians in Insulin Therapy (GAPPTM) survey, released today by Novo Nordisk. (1)

The global survey, conducted in eight countries among almost 3,000 respondents, also showed that 88% of physicians report that there are a significant proportion of patients still not reaching blood glucose targets, and four in 10 people with diabetes say they struggle to effectively control their blood sugar. These results are in line with previous research which has shown that globally less than half of people with diabetes reach an optimal level of health and quality of life.(2)

"The GAPPTM survey was designed to uncover the challenges patients and physicians are facing in obtaining effective outcomes in insulin therapy and it appears that busy lifestyles and difficulty in adhering to prescribed regimens are key contributing factors to poor glycaemic control," says Professor Luigi Meneghini, associate director at the Diabetes Research Institute, University of Miami Miller School of Medicine, Florida. He continues: "These results are consistent across countries and it is encouraging to see that physicians understand and empathise with the issues people with diabetes face."

*4.22 for basal insulin and 5.76 for meal related insulin

Busy lives make it hard to comply with prescribed regimens
Change in normal routines, being too busy or simply forgetting to take the insulin are the main reasons cited by both patients and physicians for patients missing insulin doses.

More than half of physicians agree that their patients find it hard to comply with their regimens, particularly managing the number of injections and strict time constraints of some regimens.1 These findings are supported by previous research which showed that fewer than one in five people with diabetes (19.4% of those with type 1 diabetes and 16.2% of those with type 2 diabetes) completely complied with all aspects of their prescribed regimens.(3)

Fear of hypoglycaemia may contribute to poor control
Another key factor that may contribute to poor glycaemic control is fear of hypoglycaemia. 67% of patients taking insulin are concerned about experiencing a hypoglycaemic event in the future and physicians share patients' concerns with 74% stating that they would treat closer to recommended targets if it weren't for fear of major hypoglycaemic events.(1)

People with diabetes are looking for less invasive insulin options
The survey also revealed that nine in 10 patients wish there was an insulin that could be dosed less than once a day and effectively manage blood sugar and 67% of them feel that diabetes has controlled their life since starting insulin. At the same time, the survey reveals a third of physicians are dissatisfied with current regimens' ability to fit into patients dynamic lifestyles.

About the GAPPTM Survey
The Global Attitudes of Patients and Physicians in Insulin Therapy (GAPPTM) survey was conducted in eight countries with the objective to learn what physicians and patients perceive to be the biggest functional and emotional unfulfilled needs and challenges in the management of diabetes today, specifically relating to insulin treatment. Independent research analysts conducted a 20-minute quantitative survey among 2,780 respondents in the US, UK, Germany, Spain, France, China, Japan and Turkey. The respondents were made up of 1,250 physicians (n=650 PCPs; n=600 specialists) and 1,530 insulin-using diabetes patients (n=180 type 1, n=1,350 type 2).

The survey was funded by Novo Nordisk and supported by an international panel of diabetes experts: Prof Tony Barnett, Birmingham Heartlands Hospital, UK; Prof Ji Linong, Sun Peking University, China; Prof Petra Maria Schumm-Draeger, Bogenhausen General Hospital, Germany; Dr Doron Schneider, Abington Memorial Hospital, US; Prof Luigi Meneghini, Diabetes Research, Miami, US; and Dr Shinichi Harashima, Kyoto University, Japan.

1. Global Attitudes of Patients and Physicians in Insulin Therapy (GAPP) Survey, Novo Nordisk, 2010.
2. Changing Diabetes Barometer; First Report 2007. Accessed 18 September 2010.
3. Soren E. Skovlund et al. The Diabetes Attitudes, Wishes, and Needs (DAWN) Program: A New Approach to Improving Outcomes of Diabetes Care. Diabetes Spectrum, 2005; Volume 18, Number 3: 136-142