Background and Objectives: The constantly increasing prevalence of type 2 diabetes mellitus (T2DM) and the advent of new treatment options have made management of T2DM patients more demanding. We aimed to (a) estimate the familiarity of general practitioners with novel T2DM treatment options, (b) determine whether a digital tool can aid in their treatment decisions and (c) demonstrate that an evidence-based digital clinical support tool can be made using an existing digital platform. Materials and methods: This proof-of-concept study consisted of two parts: We first conducted a simple online survey among general practitioners of three European countries to estimate their familiarity with novel T2DM treatment options and to determine whether they believe that a digital tool can aid in their T2DM treatment decisions. We then proceeded to develop a new digital tool that provides quick, evidence-based support for treatment of patients with T2DM using an existing digital platform. Results: The online survey was completed by 129/5278 physicians (94 from Italy, 22 from Czech Republic and 13 from Slovenia). Only 30.7% of all general practitioners reported to be either very or extremely familiar with novel T2DM treatments; the vast majority of participating general practitioners (82.8%) reported that they would find a digital clinical decision support tool for treating T2DM patients either very or extremely useful. A digital tool which features the characteristics deemed most important by the polled physicians was subsequently developed. Conclusions: The results of the online survey showed that familiarity of general practitioners with novel T2DM treatment options is relatively low and that there is a need for digital clinical decision support tools intended to facilitate treatment decisions in T2DM patients. We demonstrated that such a tool can easily be developed using an existing digital platform.

Department of Endocrinology Diabetes and Metabolic Disease University Medical Centre Ljubljana Zaloska 7 1000 Ljubljana Slovenia

Department of Health Promotion Sciences Maternal and Infantile Care Internal Medicine and Medical Specialties School of Medicine University of Palermo 90100 Palermo Italy

Diabetes Centre Institute for Clinical and Experimental Medicine Videnska 1958 9 140 21 Praha Czech Republic

Faculty of Medicine University of Ljubljana Vrazov trg 2 1000 Ljubljana Slovenia

Zobrazit více v PubMed

Diabetes—WHO. [(accessed on 26 July 2022)]. Available online: https://www.who.int/health-topics/diabetes.

Buse J.B., Wexler D.J., Tsapas A., Rossing P., Mingrone G., Mathieu C., D’Alessio D.A., Davies M.J. 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care. 2020;43:487–493. doi: 10.2337/dci19-0066. Erratum in Diabetes Care 2020, 43, 1670. PubMed DOI PMC

Cosentino F., Grant P.J., Aboyans V., Bailey C.J., Ceriello A., Delgado V., Federici M., Filippatos G., Grobbee D.E., Hansen T.B., et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur. Heart J. 2020;41:255–323. doi: 10.1093/eurheartj/ehz486. PubMed DOI

Das S.R., Everett B.M., Birtcher K.K., Brown J.M., Januzzi J.L., Kalyani R.R., Kosiborod M., Magwire M., Morris P.B., Neumiller J.J., et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes. J. Am. Coll. Cardiol. 2020;76:1117–1145. doi: 10.1016/j.jacc.2020.05.037. PubMed DOI PMC

American Diabetes Association 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;44:S111–S124. doi: 10.2337/dc21-S009. PubMed DOI

Rizzo M., Nauck M.A., Mantzoros C.S. Incretin-based therapies in 2021—Current status and perspectives for the future. Metabolism. 2021;122:154843. doi: 10.1016/j.metabol.2021.154843. PubMed DOI PMC

Dawwas G.K., Smith S.M., Park H. Cardiovascular outcomes of sodium glucose cotransporter-2 inhibitors in patients with type 2 diabetes. Diabetes Obes. Metab. 2019;21:28–36. doi: 10.1111/dom.13477. PubMed DOI

Mosenzon O., Alguwaihes A., Leon J.L.A., Bayram F., Darmon P., Davis T.M.E., Dieuzeide G., Eriksen K.T., Hong T., Kaltoft M.S., et al. CAPTURE: A multinational, cross-sectional study of cardiovascular disease prevalence in adults with type 2 diabetes across 13 countries. Cardiovasc. Diabetol. 2021;20:154. doi: 10.1186/s12933-021-01344-0. PubMed DOI PMC

Cardio-Metabolic Academy Europe East Adoption of the ADA/EASD guidelines in 10 Eastern and Southern European countries: Physician survey and good clinical practice recommendations from an international expert panel. Diabetes Res. Clin. Pract. 2021;172:108535. doi: 10.1016/j.diabres.2020.108535. PubMed DOI

Maranta F., Cianfanelli L., Rizzo M., Cianflone D. Filling the gap between Guidelines and Real World in the cardiovascular approach to the diabetic patients: The need for a call to action. Int. J. Cardiol. 2021;329:205–207. doi: 10.1016/j.ijcard.2020.12.074. PubMed DOI

Mosa A.S., Yoo I., Sheets L. A systematic review of healthcare applications for smartphones. BMC Med. Inform. Decis. Mak. 2012;12:67. doi: 10.1186/1472-6947-12-67. PubMed DOI PMC

Watson H.A., Tribe R.M., Shennan A.H. The role of medical smartphone apps in clinical decision-support: A literature review. Artif. Intell. Med. 2019;100:101707. doi: 10.1016/j.artmed.2019.101707. PubMed DOI

Ventola C.L. Mobile devices and apps for health care professionals: Uses and benefits. Pharm. Ther. 2014;39:356–364. PubMed PMC

Fleming G.A., Petrie J.R., Bergenstal R.M., Holl R.W., Peters A.L., Heinemann L. Diabetes Digital App Technology: Benefits, Challenges, and Recommendations. A Consensus Report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group. Diabetes Care. 2020;43:250–260. doi: 10.2337/dci19-0062. PubMed DOI

Agarwal S., Glenton C., Tamrat T., Henschke N., Maayan N., Fønhus M.S., Mehl G.L., Lewin S. Decision-support tools via mobile devices to improve quality of care in primary healthcare settings. Cochrane Database Syst. Rev. 2021;7:CD012944. doi: 10.1002/14651858.CD012944. PubMed DOI PMC

Rizvi A.A., Stoian A.P., Rizzo M. Metabolic Syndrome: From Molecular Mechanisms to Novel Therapies. Int. J. Mol. Sci. 2021;22:10038. doi: 10.3390/ijms221810038. PubMed DOI PMC

Rizzo M., Rizvi A.A., Patti A.M., Nikolic D., Giglio R.V., Castellino G., Li Volti G., Caprio M., Montalto G., Provenzano V., et al. Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: An 18-month prospective study. Cardiovasc. Diabetol. 2016;15:162. doi: 10.1186/s12933-016-0480-8. PubMed DOI PMC

Nikolic D., Giglio R.V., Rizvi A.A., Patti A.M., Montalto G., Maranta F., Cianflone D., Stoian A.P., Rizzo M. Liraglutide Reduces Carotid Intima-Media Thickness by Reducing Small Dense Low-Density Lipoproteins in a Real-World Setting of Patients with Type 2 Diabetes: A Novel Anti-Atherogenic Effect. Diabetes Ther. 2021;12:261–274. doi: 10.1007/s13300-020-00962-3. PubMed DOI PMC

Janež A., Fioretto P. SGLT2 Inhibitors and the Clinical Implications of Associated Weight Loss in Type 2 Diabetes: A Narrative Review. Diabetes Ther. 2021;12:2249–2261. doi: 10.1007/s13300-021-01104-z. PubMed DOI PMC

Nikolic D., Patti A.M., Giglio R.V., Chianetta R., Castellino G., Magán-Fernández A., Citarrella R., Papanas N., Janez A., Stoian A.P., et al. Liraglutide Improved Cardiometabolic Parameters More in Obese than in Non-obese Patients with Type 2 Diabetes: A Real-World 18-Month Prospective Study. Diabetes Ther. 2022;13:453–464. doi: 10.1007/s13300-022-01217-z. PubMed DOI PMC

Haluzík M., Hrádková V., Kudláčková M., Jakubíková I. Obesity treatment in patients both with and without diabetes: Current options and perspectives. Cas. Lek. Ceskych. 2020;159:136–140. PubMed

Jensterle M., Janež A. Glucagon Like Peptide 1 Receptor Agonists in the Treatment of Obesity. Horm. Res. Paediatr. 2021 doi: 10.1159/000521264. ahead of print . PubMed DOI

Stoian A.P., Banerjee Y., Rizvi A.A., Rizzo M. Diabetes and the COVID-19 Pandemic: How Insights from Recent Experience Might Guide Future Management. Metab. Syndr. Relat. Disord. 2020;18:173–175. doi: 10.1089/met.2020.0037. PubMed DOI PMC

Ceriello A., Stoian A.P., Rizzo M. COVID-19 and diabetes management: What should be considered? Diabetes Res. Clin. Pract. 2020;163:108151. doi: 10.1016/j.diabres.2020.108151. PubMed DOI PMC

Rizvi A.A., Janez A., Rizzo M. Cardiometabolic Alterations in the Interplay of COVID-19 and Diabetes: Current Knowledge and Future Avenues. Int. J. Mol. Sci. 2021;22:12311. doi: 10.3390/ijms222212311. PubMed DOI PMC

Al Mahmeed W., Al-Rasadi K., Banerjee Y., Ceriello A., Cosentino F., Galia M., Goh S.Y., Kempler P., Lessan N., Papanas N., et al. Promoting a Syndemic Approach for Cardiometabolic Disease Management During COVID-19: The CAPISCO International Expert Panel. Front. Cardiovasc. Med. 2021;8:787761. doi: 10.3389/fcvm.2021.787761. PubMed DOI PMC