title: Clinical significance of barriers to blood glucose control in type 2 diabetes patients with insufficient glycemic control.
abstract: BACKGROUND
  The purpose of this study was to assess actual barriers to blood glucose control in patients with type 2 diabetes mellitus and to investigate barrier-related factors in an exploratory manner.
  
  
  METHODS
  This cross-sectional study assessed patients with type 2 diabetes mellitus treated as outpatients at medical institutions within Fukuoka Prefecture, Japan. Barriers to blood glucose control were examined in patients with glycated hemoglobin ≥6.9% using a nine-item questionnaire. Answers were also obtained from physicians in charge of the patients for seven of nine questions.
  
  
  RESULTS
  Seven hundred and thirteen patients answered the questionnaire. Many physicians and patients described barriers that involved difficulty in complying with diet therapy. For six of the seven barriers, patient awareness was lower than physician awareness. Patient-reported lack of concern for diabetes mellitus was more prevalent among patients with macrovascular complications. Patients who reported difficulty in compliance with exercise therapy and fear of hypoglycemia were more likely to suffer from microvascular complications.
  
  
  CONCLUSIONS
  For many of the barriers to blood glucose control, patients were less aware than physicians, suggesting that we need to take action to raise patient awareness. Of interest are the observations that the relevant barriers differed for macrovascular and microvascular complications and that the relationship between presence of macrovascular complications and lack of concern about diabetes mellitus.
authors.affiliation: Development and Medical Affairs Division, GlaxoSmithKline K.K., Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Takei
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan.
authors.forename: Toyoshi
authors.initials: T
authors.lastname: Inoguchi
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan ; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sonoda
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Development and Medical Affairs Division, GlaxoSmithKline K.K., Tokyo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kaise
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
keywords: diabetic complications; epidemiology; patient awareness; patient behavior; patient education