1. MGSD Studies • Educationalstudy:C. Savona-Ventura (Malta)

2. Healthcare professionals’ perceptions of T2DM care in the Mediterranean region MGSD-Education Study Group Prof. Charles Savona-Ventura [Lead Investigator] Prof. Mohamed Khattab Prof.NebojsaLalic Prof. Stavros Liatis Prof. Filipe Raposi Prof. Pedro Conthe

3. Introduction • Background: The views and perceptions of healthcare professions towards T2DM care can have an influence of patient outcomes. Awareness of these views/perceptions is an essential pre-requisite prior to undertaking any educational programme. • Objective of study • To assess the views and perceptions of primary and hospital-based healthcare professionals, and members of professional bodies and their trainees in the Mediterranean region towards T2DM care as this relates to: • Practice organization • Clinical issues relating to diagnosis and complications • Attitudes to diabetes, obesity and weight control • Use of clinical guidelines including recommended targets of control • To further assess: • The level of knowledge of healthcare professionals • Their perception towards the disease, and • The degree of adherence to published guidelines • To provide an educational baseline picture which would allow dedicated educational programmes to be designed for the region.

4. Methodology • Self-administered questionnaire filled in: • Using internet facilities through the MGSD website • Using hard copy questionnaire distribution during relevant professional meetings • Professional bodies in the various countries in the Mediterranean region were invited to circulate a notice to their members asking them to participate in the study. • Target populations : primary health care physicians, diabetologists, endocrinologists & internists, both in public and private sectors, national societies. • Data from web-based and paper responses collated in an excel file. • Descriptive statistics.

5. Population characteristics Total population: 2884 EAST WEST SOUTH

6. Population characteristics Total population: 2884

7. CME characteristics Total population: 2884 Mean number of years since graduation 18.7+11.1 yrs 18.9+11.1 yrs 19.4+10.7 yrs 19.0+11.3 yrs

8. Practice characteristics Total population: 2884 Self Confidence re management Aware of team management facilities Aware of country specific guidelines

9. Treatment Choice problems Total population: 2884 Second line therapeutic choices after metformin failure Perceived problems to using Insulin Perceived problems to using Insulin

10. Treatment Choice problems Total population: 2884 Confidence in patient/family capability to manage hypoglycaemia HbA1c targets Hypoglycaemia conceived as a problem influencing choice of management

11. GDM issues Total population: 2884 Choice of diagnostic criteria Facility availability for pre-conceptional care

12. GDM issues Total population: 2884 Adoption of insulin analogues in management of GDM Adoption of OHA in management of GDM

13. Conclusions Total population: 2884 • 29% not confident about T2DM management • 46% report no Team management facilities • 21% report no country specific guidelines • 2nd line medication to metformin are sulphonylureas & DPP4 inhibitors • 53% perceive insulin use as a problem • 24% consider hypoglycaemia as a problem sufficient to influence management choices • 24% consider the patients & care-supporters as not capable of managing hypoglycaemia • Only 21% prefer to keep HbA1c levels below 6.5% • 8% accept threshold up to 7.5% • 4% even up to 8.0% • 28% reported Pre-conceptional care facilities • Diagnostic criteria: 22% old WHO criteria; 18% IADPSG; 18% ADA • 23% ready to use OHA for GDM • 60% ready to use Insulin analogues for GDM