Unmet Needs for Patients With T1D Include Simplified Management, Weight Loss

A diabetic patient checks her blood sugar levels on a glaucometer. She has a worried expression on her face. The woman is of Chinese descent.
Researchers sent adults with type 1 diabetes a quantitative survey in order to better understand unmet needs and patient preferences.

Unmet needs of patients with type 1 diabetes (T1D) include simplifying treatment, lowering/maintaining glycated hemoglobin (HbA1c), reducing mental effort, and increasing time in range, according to study results published in Diabetes Technology & Therapeutics.

The results also indicated that patients with T1D have a preference for adjunct therapies that can help address these needs.

The researchers sent adults with T1D (n = 2084) a quantitative survey in November 2017 in order to better understand unmet needs and patient preferences. The researchers used the common market research “jobs-to-be-done” technique and performed conjoint analyses on survey responses to evaluate the importance of treatment-associated benefits and risks to participants.

The survey included a 5-point Likert scale that measured the importance and satisfaction of participants’ current therapy and gaps relating to unmet needs. For the conjoint analysis, participants chose between “packages” of attributes based on established benefits and side effects of 2 dosages of adjunct therapy (sotagliflozin 200 and 400 mg) and placebo (insulin only).

Of 2084 patients, 1313 (63%) responded. Using these responses, the researchers identified simplifying treatment, lowering/maintaining HbA1c, reducing mental effort, and increasing time in range as major jobs to be done (ie, significant unmet needs) in T1D care.

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The results of the conjoint analysis indicated that reducing body weight and increasing time in range had the highest attribute importance (25% and 18%, respectively).

The researchers also found that 93% of participants had a preference for adjunct therapy compared with placebo, despite the potential side effects.

“This survey highlights that there are still many unmet needs in type 1 diabetes, including achievement of glycemic control targets (HbA1c <7% [<53 mmol/mol]), prevention of weight gain, increased time spent in the optimal blood glucose range, and a desire for simpler diabetes management,” the researchers wrote.


Pettus JH, Kushner JA, Valentine V, et al. Adjunct therapy in type 1 diabetes: a survey to uncover unmet needs and patient preferences beyond HbA1c measures. Diabetes Tech Ther. 2019;21(6):336-343.