Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes: a path analysis model

Overcoming Barriers to Injectable Therapies: Development of the ORBIT Intervention Within a Behavioural Change Framework

“…Poor injectable uptake and adherence have been attributed to "significant barriers in the minds of patients" [(6), s12]. Psychological aspects such as individuals' perceptions of injectables, depression, anxiety, fear of injections, perceived pain, feelings of shame and failure can impact on engagement with therapies of this type (7)(8)(9). These psychological aspects are associated with poorer: clinical outcomes, initiation of injectable therapies, medication adherence and motivation which impact negatively on effective self-management behaviours (9)(10)(11)(12)(13).…”

“…People with diabetes report concerns around treatment complexity, the restrictive nature of injectable regimens and the impact on day-to-day living ( 17 ). Poor knowledge about the use of injectables, particularly insulin, can affect confidence in their use ( 9 ). This, in turn, serves to increase the risk of associated complications, increase diabetes related distress, and adversely affect glycaemic control ( 9 , 11 ).…”

“…Poor knowledge about the use of injectables, particularly insulin, can affect confidence in their use ( 9 ). This, in turn, serves to increase the risk of associated complications, increase diabetes related distress, and adversely affect glycaemic control ( 9 , 11 ).…”

“…There has been significant underinvestment in interventions which target behaviour change with greater focus on the development of medications and devices to affect better outcomes ( 19 ). Overcoming the challenges presented by injectable therapy would be best served through an educational intervention ( 6 , 9 ). However, the intervention must reflect best practice guidelines for structured diabetes education ( 20 ), respond to practical aspects of injectable use, and address psychological barriers to injectable uptake and maintenance ( 6 , 9 , 21 ).…”

Psychological comorbidity in diabetes mellitus—need for early recognition and treatment

“…Emre et al [7] also report a high prevalence of anxiety and depression in diabetic patients who also had hypertension in their primary care settings which adversely impacted both blood pressure and blood sugar control. The impact of psychosocial factors on glycemic control was assessed by Aghili et al [8] who report higher rates of distress, depression, and anxiety in insulin-experienced diabetic patients compared to those who were insulin-naïve. These patients also had higher HbA1C levels suggesting poorer control of glycaemia.…”