The Optimizing Control in Diabetes (OPTIMIZE) survey involved 1,500 people in seven countries and was conducted on behalf of pharmaceutical firm Pfizer. It found that 64 per cent of people who had had type-2 diabetes for more than 10 years were still not achieving optimum blood sugar levels, as set out by organizations such as the International Diabetes Federation (IDF).
The problem seemed to affect both those taking insulin (55 per cent) and oral agents (69 per cent).
"These findings are really very worrying," said Professor Massi-Benedetti , VP of the IDF. "The OPTIMIZE Survey provides us with a real insight into the attitudes of people with diabetes about their condition, and the findings indicate that, despite the availability of insulin, a natural and effective way to control blood sugar, levels of control are sub-optimal at a global level.
"It is vital that we address why people are not getting to target levels, in order to reduce the growing incidence of the devastating complications associated with diabetes."
Diabetes is the fourth leading cause of death worldwide, and complications associated with the disease include blindness, amputations, kidney failure, heart attack and nerve damage.
An estimated 175m people suffer from type-2 diabetes around the world, of which 19m live in the EU. The EU figure is projected to increase to 26 million by 2030, which could have a dramatic effect on health care costs.
The survey was designed in part to give diabetes sufferers a chance to express their views of available ways to managing the disease.
Although insulin remains the most effective course of action, it appears that many sufferers are put off using it because of the necessity for injections.
Of the respondents currently using oral pills and/or diet and exercise, almost half said that they would avoid insulin even if it was recommended by a physician, and a further 13 percent said they would be apprehensive.
Although diabetes is a disease that worsens over time, considerable R&D spend has been devoted to finding supplements to support conventional treatments or lifestyle approaches that may put off the need for patients to take insulin for longer.
These include US company Nutrition 21, which has conducted trails in Native American communities (where diabetes rates are particularly high) using its Diachrome chromium picolinate and biotin formulation.
Diachrome is marketed as a daily supplement taken in conjunction with conventional medications to treat diabetes. A cost analysis last year found that it could save as much as $52.9 billion in US health care costs for diabetes sufferers over three years.
A study published online by the Journal of Applied Physiology (15th December, doi:10.1152) suggested that following the 'Pritikin' diet, which is rich in whole grains, vegetables and fruit, could control diabetes in some to such an extent that there is no longer a need for medication.
The results of the OPTIMIZE survey were discussed by leaders in the diabetes field from 16 countries at a meeting in London in March. Their conclusions will be presented at a major diabetes congress later this year.