Determining the Perception and Willingness of Primary Care Providers to Prescribe Advanced Diabetes Technologies

Primary care providers’ experience in the management of paediatric type 1 diabetes in Western Sydney, New South Wales

“…O'Donovan et al have highlighted that primary care practitioners are usually hesitant to initiate or adjust insulin pump therapy; however, they recognise the advantages this treatment could offer. 30 Given that diabetes technologies such as insulin pumps and CGM are associated with better glycaemic control, 31 and therefore better patient outcomes, it is imperative that GPs can troubleshoot and encourage adherence to such diabetes technologies. Pease et al identified the need to establish clear guidelines on the commencement and monitoring of diabetes technologies across all healthcare sectors, including the role of primary care providers and appropriate scope of practice, which is again highlighted here.…”

Addressing the Burden of Multiple Daily Insulin Injections in Type 2 Diabetes with Insulin Pump Technology: A Narrative Review

“…Another barrier to optimizing insulin therapy is underutilization of diabetes technologies. In a recent cross-sectional survey of 76 primary care providers, the majority of respondents reported they were uncomfortable initiating (88%) or adjusting (89%) conventional insulin pump therapy for their patients with T2D [ 30 ]. In another cross-sectional pilot survey that included 41 rural clinic healthcare providers, less than half (47.4%) reported prescribing any diabetes devices due to lack of experienced personnel to provide initial training and ongoing insulin management [ 31 ].…”

“…Use of insulin pump therapy in individuals with T2D improves glycemic control [ 37 ], increases treatment satisfaction [ 37 ], reduces bodyweight [ 36 ], and improves quality of life in adults previously treated with MDI [ 38 ]. However, therapy with conventional insulin pumps, which are small computerized devices that are worn outside the body and deliver insulin into the subcutaneous tissue through an infusion set, remains under-utilized [ 39 ] due to a variety of factors, including negative perceptions by patients (cost, complexity, pain, complexity) [ 40 ], clinician perception of patient acceptance [ 41 ], clinician time/resource constraints, and clinician inexperience with initiating insulin pump therapy [ 30 ]. Kinking of the tubing with conventional pumps can also be a serious issue, which can result in reduced, delayed, interrupted, or failed infusion of insulin and subsequent hyperglycemia [ 40 ].…”