Treatment burden and perceptions of glucose-lowering therapy among people living with diabetes

Prim Care Diabetes. 2022 Aug;16(4):568-573. doi: 10.1016/j.pcd.2022.04.002. Epub 2022 Apr 21.


Aims: Address treatment burden and general perceptions of pharmacological treatment in patients with diabetes.

Methods: We surveyed adult patients with diabetes cared for in a tertiary academic medical center about: i) knowledge about the impact of glucose-lowering medication use on diabetes control and complications, ii) common beliefs about natural medicine and insulin use, iii) attitudes towards glucose-lowering medications, iv) burden of treatment, v) general knowledge of diabetes pharmacological treatment, and vi) perceptions of shared decision-making.

Results: Two hundred-four participants completed the survey. While most (90%) agreed that adherence to medication would control diabetes and improve quality of life, 30-40% were not certain that it would translate to fewer disease complications. About one of three thought medications could be harmful (29.4%). Over 50% agreed or was unsure that natural remedies were as good/better than prescribed medications. About 30% acknowledged difficulties taking their diabetes medications and monitoring blood glucose, and over 50% were concerned about treatment costs. Nearly 30% denied receiving a detailed explanation from their clinician regarding their disease and is treatment.

Conclusions: Our results highlight the importance of patient education regarding pharmacological treatment for diabetes, and eliciting sources of distress and treatment burden among patients with diabetes.

Keywords: Burden of treatment; Diabetes; Financial burden; Medication adherence; Patient reported outcomes; Shared decision-making.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus, Type 2*
  • Glucose
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Medication Adherence
  • Quality of Life


  • Hypoglycemic Agents
  • Glucose