Psychological insulin resistance: scope of the problem

Luk, Andrea O. Y.

doi:10.12809/hkmj165025

Cited by 4 publications

(7 citation statements)

References 22 publications

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“…The 5As program recommended specific approaches to address insulin use barriers (20), but most of the recommended strategies involved explaining the reasons for prescribing insulin and teaching the patient how to simplify insulin administration. Some studies reported that PIR can be influenced by culture, age, sex, and socioeconomic status (11), as well as linked with individual psychological states, such as depression and distress (21). As such, educational approaches focused on the medical aspect of insulin therapy alone may be limited in their ability to reduce PIR among some insulin-naïve patients.…”

Section: Discussionmentioning

confidence: 99%

“…As such, educational approaches focused on the medical aspect of insulin therapy alone may be limited in their ability to reduce PIR among some insulin-naïve patients. Luk stated that 'healthcare providers should be alerted to the multi-dimensional nature of PIR' (21). Nevertheless, the need remains for further comprehensive research to better understand the factors related to PIR and how to address them with patients.…”

Section: Discussionmentioning

confidence: 99%

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The prevalence of insulin refusal and psychological insulin resistance among Korean patients with type 2 diabetes mellitus

Song¹,

Ku²,

Cho³

et al. 2019

Ann Transl Med

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Background: This study investigated the prevalence of insulin refusal and compared the level of psychological insulin resistance (PIR) with the intention to accept insulin therapy among Korean patients with type 2 diabetes.Methods: Type 2 diabetes patients (n=1,209) were recruited from inner city outpatient diabetes clinics in 2016. Patient demographic, insulin recommendation, diabetes treatment type, intention to receive insulin therapy, and PIR information was collected using self-reports. The patients were divided into three groups: those who refused insulin therapy (n=184), those who accepted insulin therapy (n=331), and those not recommended for insulin therapy (n=694). Descriptive statistics were used to calculate the prevalence of insulin refusal; t-tests and analyses of variance were used to compare demographics with PIR.Results: The insulin refusal rate was 35.7%. The duration of diabetes, numbers of diabetes-related complications, and glycated hemoglobin levels were significantly lower in the group not recommended for insulin therapy than refused and accepted insulin groups. The level of PIR in insulin refusal group was significantly lower among patients agreeing to receive insulin therapy within 3 months than among those refusing insulin therapy. Conclusions:The prevalence of insulin refusal in Korea is not low, and people who refuse insulin therapy have high levels of PIR. Strategies to reduce PIR levels are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The prevalence of insulin refusal and psychological insulin resistance among Korean patients with type 2 diabetes mellitus

Song¹,

Ku²,

Cho³

et al. 2019

Ann Transl Med

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“…The prevalence of insulin refusal and rejection is between 20% and 40% among insulin-naïve people with T2DM. Also, adherence to insulin therapy among existing insulin users is suboptimal among one-third of patients with T2DM [5].Timely initiation of insulin therapy reduces the risk of micro-and macrovascular complications. Therefore, the identification of barriers to insulin initiation is important [6].…”

Section: Prevalence Of Psychologic Insulin Resistancementioning

confidence: 99%

A Practitioner’s Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel

et al. 2020

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Aim: To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner's toolkit for insulin motivation in the management of diabetes mellitus (DM). Background: Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician-and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of

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“…In spite of the proven efficacy of initiation of insulin in any case of type 2 diabetes mellitus it becomes tremendously diffi-cult to do so, in the face of vehement psychological resistance exhibited by the patients 5 . Sometimes, glycaemic control becomes very much at bay because of the patient's resistance to start or intensify insulin therapy 6,7 .…”

Section: Introductionmentioning

confidence: 99%

“…Psychological insulin resistance is a phenomenon that describes barriers to start insulin therapy 10 . The assessment of knowledge and attitude of patients with diabetes mellitus towards insulin therapy becomes essential because it is postulated that concepts and beliefs towards insulin therapy affect the compliance of therapy and ultimately diabetic control and its complications.…”

Section: Introductionmentioning

confidence: 99%

Reluctance of Patients With Diabetes Mellitus to Insulin Therapy; Psychological Insulin Resistance

Ali

Munir²,

Maqsood³

et al. 2021

PAFMJ

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Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019. Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naïve, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), difficult insulin storage 98 (76.6%), risk of hypoglycemia 82 (64.1%).The mean negative perception Score was 7.35 (SD 0.98). Conclusion: Psychological insulin resistance is present in significant diabetic population, and it is a big obstacle in insulin therapy initiation and compliance.

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Psychological insulin resistance: scope of the problem

Cited by 4 publications

References 22 publications

The prevalence of insulin refusal and psychological insulin resistance among Korean patients with type 2 diabetes mellitus

The prevalence of insulin refusal and psychological insulin resistance among Korean patients with type 2 diabetes mellitus

A Practitioner’s Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel

Reluctance of Patients With Diabetes Mellitus to Insulin Therapy; Psychological Insulin Resistance

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