OBJECTIVES : To compare patient characteristics, resource use and involvement in patients achieving/not achieving physician set HbA1c targets.

METHODS : Data were drawn from 2018 Adelphi Disease Specific Programme, a real-world, cross-sectional study in 5EU/USA. Physicians completed forms for the next 10 T2DM patients capturing demographics, clinical characteristics, disease duration, HbA1c targets, comorbidities, patient knowledge/involvement in their condition, resource use. Patients were classified into one of the following groups: Unmet target [1] HbA1c <7.5%, [2] HbA1c >7.5%, met target [3] HbA1c <7.5%, [4] HbA1c >7.5%.

RESULTS : Of 7372 patients included in the analysis, 6968 had HbA1c target <=7.5%; 46.3% currently achieving this with 403 having target >7.5% (41.3% achievement). Top reasons driving targets >7.5%: age (46%), non-compliance (33%), low patient engagement (31%), risk of hypoglycemia (26%) and weight concerns (19%). Patients unsuccessful at meeting goal ([1]/[2]) versus those successful ([3]/[4]) are more likely to be younger (59.4/63.5 vs. 61.8/69.6 [years]), working full-time (50/26% vs. 44/22%), have more comorbidities (2.8/4.4 vs. 2.6/4.1), high/very high cardiovascular risk (27/50% vs. 22/39%), total number of prescribed products (4.8/7.2 vs. 4.5/6.3 [per day]) and diabetologist visits (1.3/1.4 vs. 1.0/0.9 [per annum]). Unsuccessful patients are also more likely to have faster than average speed of disease progression (17/43% vs. 6/11%), have no knowledge (21/37% vs. 15/26%) or no involvement (26/46% vs. 22/30%) about treatment options. All results p<0.05

CONCLUSIONS : Whilst clinical guidelines advocate stringent HbA1c targets around 7.5%, it is recognized this differs in a real-world setting due to patient factors like age, risk of hypoglycemia and weight concerns. T2DMs not meeting goal not only contribute to healthcare system burden but are of working age. Given their lack of engagement, to help patients meet targets, physicians should place a greater emphasis on patient education and empowerment to promote more patient responsibility for their own health.