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Master Thesis

Place of GLP1 receptor agonists in type 2 diabetes in primary care : practices and representations of general practitioners in Ille-et-Vilaine and Morbihan

Abstract : INTRODUCTION: Diabetes is affecting more and more people around the world and doing so is a major public health issue. Since 2008, glucagon-like-peptide 1 receptor agonists (GLP1 RA) have received marketing authorization in the treatment of type 2 diabetes not adequately controlled by lifestyle modifications and metformin. The general practitioner is often the first to initiate and optimize this treatment. This work aims to analyse the integration and representations concerning GLP1RA in the practice of general practitioners in the departments of Ille-et-Vilaine and Morbihan. METHODES: 16 general practitioners from Ille-and-Vilaine and Morbihan participated in semi-directive interviews between February and July 2020. RESULTS: For participating physicians, the follow-up of the diabetic patient involved both monitoring the balance of diabetes, the intervention of a network of health professionals and the patient's adherence to management. Therapeutic intensification often occurred after 6 months of disease imbalance. In this context, several doctors interviewed introduced a GLP1RA. Dulaglutide and liraglutide were the preferred molecules for their medical appeals. Those who didn’t initiate GLP1RA mainly spoke of a lack of knowledge and distrust of these therapies but did the renewal if the diabetologist had introduced it. Doubts about their iatrogenesis, the lack of updated guidelines, and the consequences of therapeutic scandals in diabetes were factors limiting the use of these molecules. The patient's adherence to follow-up and his representations on diabetic disease were all potential sources of hindrance for the physician. DISCUSSION/CONCLUSION: In the therapeutic adaptation of type 2 diabetes, GLP1RA are only partially integrated into the practice of general practitioners. The positions of learned societies are little known and the lack of updated HAS guidelines despite the arrival of new treatments complicate the management of the disease for primary care physicians. Encouraging patient’s adherence through shared medical decision-making is an essential element. It becomes essential to make the patient an actor in his follow-up, in his concerning therapeutic decisions and his health. Training physicians in The Therapeutic Education of the Patient and facilitating its access to the territory will optimize the use of the anti-diabetic therapeutic arsenal, which includes GLP1RA.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03543677
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Submitted on : Wednesday, January 26, 2022 - 10:48:18 AM
Last modification on : Wednesday, March 16, 2022 - 3:37:28 AM
Long-term archiving on: : Wednesday, April 27, 2022 - 6:33:07 PM

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Priscilla Poissel. Place of GLP1 receptor agonists in type 2 diabetes in primary care : practices and representations of general practitioners in Ille-et-Vilaine and Morbihan. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03543677⟩

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