Patient preferences for diabetes management among people with type 2 diabetes in Denmark - a discrete choice experiment

Objectives: To study patient preferences for diabetes-treatment related attributes among people with type 2 diabetes. Research design and methods: Participants were recruited from three diabetes out-patient clinics and two general practitioner surgeries. Data were collected electronically and results were analysed using a standard statistical model designed for choice sets (conditional logit), Six characteristics relating to treatment of diabetes were examined: glycated haemoglobin level (HbA(1c)), weight (gain or loss), hypoglycaemic events, need for injections, transient nausea and need for blood glucose testing. Results: Two hundred and seventy participants with type 2 diabetes (178 males, 92 females) were included. Patients placed the most value on losing weight and were willing to pay the most to lose 6 kg of weight. Loss of 3 kg of weight was the next highly valued, followed by dropping one percentage point in HbA(1c) level. Avoidance of nausea and a reduction in hypogaycaemic events from two per month to none was also highly valued. Patients were willing to accept one injection per day if they, for instance, simultaneously lost 1.4 kg. A limitation of the study is that the survey was web-based and response rates for such surveys can be extremely variable. Conclusion: Patients with type 2 diabetes in Denmark were willing to pay for the health benefits associated with improved diabetes treatment the most important of these being weight loss or avoidance of weight gain, and reduction of HbA1c, and of hypoglycaemic events.