Ibrahim El - Bayoumy
Tanta University, Egypt
Title: Identifying and addressing barriers for insulin use in patients with type 2 diabetes mellitus
Biography
Biography: Ibrahim El - Bayoumy
Abstract
Diabetes mellitus type 2 is characterized by gradual decrease in insulin sensitivity in the peripheral tissues and liver(insulin resistance),followed by gradual decline in Beta cell function and insulin secretion. Thus patients with poor glycaemic control require the use of insulin therapy to achieve the target of American Diabetes Association, recommending HbA1c to be less than7%.≥ 8% despite of optimal doses of anti-diabetic drugs
This study aimed to evaluate and addressing the barriers for use of insulin in type 2 diabetes mellitus patients ,where their glycaemic control is poor i.e. HbA1c is .≥ 8% despite of optimal doses of anti-diabetic drugs.
We surveyed 200 patients with type 2 diabetes mellitus i.e. cross sectional quantitative study, patients showed poor glycaemic control HbA1c ≥ 8%,already treated with one or more oral agents, who recently prescribed insulin to control their metabolic status . Data were obtained by patient’s interview using a validated questionnaire The place of the study was in diabetes mellitus clinic in Farwaniyah primary health care center in Kuwait
Patients with type 2 diabetes failing to initiate the prescribed insulin therapy have reported misconception regarding fear of hypoglycaemia in 49% of the total sample ,pain from injections in 68% ,and self blame about need for insulin i.e. sense of failure in 61% of total sample of study. Other factors were addressed like sensation by getting more severity of the disease, weight gain fear and other negative self perceptions and attitudinal barriers were studied.
Reducing the negative influence of psychological insulin resistance (PIR) on treatment outcomes should be a clinical priority. Approaching and understanding the multifaceted and complex nature of PIR and discussing the etiology of every patient's PIR is the first important step. The incorporation of well-validated clinical measures assessing these barriers, as well as further research should be conducted on the impact of interventions to overcome such barriers. Clinicians should prescribe simple insulin regimen to decrease their patients' fear from dependency of insulin, and the use of modern insulin analogs and insulin pen services, may greatly reduce PIR by mitigating the fear of life style changes and side effects, as well as social stigma associated with using insulin in a vial and syringe