Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study

Abstract

ObjectiveTo explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin.Research designA qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach.ParticipantsSeventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year.SettingThe Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia.ResultsData analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care.ConclusionsFactors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients’ concerns during consultations and help to improve glycaemic control.

Influencing factors on compliance of timely visits among patients with proliferative diabetic retinopathy in southern China: a qualitative study

“…These cases indicate that lack of insulin related knowledge in some patients resulted in insulin use disorders or poor adherence. These concerns are likely to affect patients' use of insulin, resulting in poor control of blood sugar 22. Intensive therapy with insulin in patients with type 1 diabetes was associated with a substantial reduction in the long term risk of ocular surgery 23.…”

“…In addition, we found that some DM patients had concerns about the use of insulin. Tong et al 22 reported that psychosocial and emotional barriers were associated with poor glycaemic control in people with type 2 DM using insulin. Such psychological concerns leading to poor glycaemic control could promote the progression of DR.…”

Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco

“…The variable of occupation was significantly associated with glycemic control for housewives/students. Other studies (8)(9)17) have suggested that having an occupation (represented in the forms of occupation and housewife/student categories) corresponds to a risk factor for the occurrence of inadequate glycemic control. This may be associated with the fact that people with DM that have an occupation have less free time to manage and monitor their illness (8) , a justification also applied to housewives and students.…”

A patient-centric approach to optimise insulin therapy in Asia

“…• Fear of side effects such as weight gain, hypoglycaemia (Tong, Vethakkan, & Ng, 2015;Wong et al, 2011;Funnell, 2007) • Fear of needles, experiencing pain at the injection site and injecting themselves (Tong et al, 2015;Wong et al, 2011;Funnell, 2007;Abu et al, 2013) • Social stigma associated with insulin use Funnell, 2007;Abu et al, 2013) Change perception through patient education • Engage and educate patients in the early stages of diabetes on how to achieve optimal glycaemic control • Emphasise the long-term benefits of timely insulin intervention • Use web-based technology to enable education of a larger number of patients…”