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Table 2 All reasons selected by general practitioners for non-treatment of patients with type 2 diabetes mellitus

From: Reasons given by general practitioners for non-treatment decisions in younger and older patients with newly diagnosed type 2 diabetes mellitus in the United Kingdom: a survey study

Reasons, n (%) Patients < 65 years n = 1, 023 Patients ≥65 years n = 1, 005 p-value
Mild Hyperglycaemia 897 (87.7) 866 (86.2) 0.323
   HbA1c value stable, drug therapy not necessary 278 (27.2) 264 (26.3) 0.652
   HbA1c value close to NICE recommended threshold 316 (30.9) 326 (32.4) 0.474
   Blood glucose values under control with diet and exercise 301 (29.4) 330 (32.8) 0.103
Factors Related to Antihyperglycaemic Agents 386 (37.7) 463 (46.1) < 0.001
   May cause hypoglycaemia 176 (17.2) 250 (24.9) < 0.001
   May cause fluid retention 67 (6.6) 98 (9.8) 0.009
   May cause weight gain 173 (16.9) 157 (15.6) 0.435
   May cause gastrointestinal side effects 203 (19.8) 200 (19.9) 0.999
   May increase risk of fracture 45 (4.4) 68 (6.8) 0.026
   May increase cardiovascular risk 49 (4.8) 68 (6.8) 0.057
   May increase risk of lactic acidosis 78 (7.6) 96 (9.6) 0.132
   Uncertainty how to dose certain drug 26 (2.5) 25 (2.5) 0.999
   Not clear if several agents are safe 30 (2.9) 34 (3.4) 0.612
   Efficacy of agents not clear 30 (2.9) 24 (2.4) 0.492
   Safety of agents not clear 34 (3.3) 30 (3.0) 0.704
   Primary Care Trust cost concerns 24 (2.4) 26 (2.6) 0.776
   Cognitive burden of therapy administration too high for patient 66 (6.5) 121 (12.0) < 0.001
   Cognitive burden of monitoring glucose too high for patient 48 (4.7) 87 (8.7) < 0.001
   Difficulties/ability to change patient's lifestyle 118 (11.5) 119 (11.8) 0.836
   Risk of non-compliance (not related to side effects) 115 (11.2) 132 (13.1) 0.198
   Risk of non-compliance due to side effects 80 (7.8) 115 (11.4) 0.007
   Lack of monitoring due to physical limitations (e.g., dexterity) 32 (3.1) 82 (8.2) < 0.001
Comorbidities and Polypharmacy 192 (18.8) 333 (33.1) < 0.001
   Patient has other severe disease(s) 69 (6.7) 172 (17.1) < 0.001
   Medical diabetes treatment is contraindicated 27 (2.6) 38 (3.8) 0.166
   Patient is taking several other medications already 108 (10.6) 216 (21.5) < 0.001
   Risk of side effects (related to polypharmacy) 124 (12.1) 191 (19.0) < 0.001
   Risk of drug-drug interactions (related to polypharmacy) 60 (5.9) 100 (10.0) < 0.001
Patient-Related Reasons 443 (43.2) 416 (41.4) 0.419
   Patient denial/anger/depression related to diabetes diagnosis 120 (11.7) 108 (10.8) 0.527
   Patient's follow-up visit is overdue 92 (9.0) 64 (6.4) 0.030
   Patient does not want to take (additional) medication 325 (31.8) 305 (30.4) 0.502
   Fear of hypoglycaemia 71 (6.9) 93 (9.3) 0.061
   Fear of weight gain 112 (11.0) 78 (7.8) 0.015
   Fear to change from diet/exercise to oral agents 100 (9.8) 88 (8.8) 0.445
   Fear to change from diet/exercise to insulin 54 (5.3) 53 (5.3) 0.999
   Patient has physical difficulty taking medication 29 (2.8) 44 (4.4) 0.073
   Drug therapy decreases quality of life 61 (6.0) 76 (7.6) 0.158