PSYCHOLOGICAL BARRIERS TOWARDS EARLY INSULIN INITIATION IN UNCONTROLLED TYPE 2 DIABETIC PATIENTS.

Abstract

Objective: To determine the frequency of patients' related psychological factors that delay timely insulin initiation in uncontrolled type 2 diabetic patients presenting to a teaching hospital.

Methodology: This was a descriptive study performed in Lady reading Hospital, Medical Teaching Institution, Peshawar from February 2017 to February 2018. Three hundred patients of type 2 Diabetes who were not achieving target HbA1c were enrolled in the study by simple random sampling. A questionnaire was filled of each patient, after consent, including their age, sex, and occupation, duration of diabetes, HbA1c level, current medications and reasons for insulin refusal. SPSS version 20 was used for data interpretation.

Results: Three hundred patients [168(54%) female and 132(46%) male] were included in the study. Requirement of healthcare personnel to inject insulin (91.33%) followed by fear of injection (85.33%), fear of hypoglycemia (84%), insulin therapy being lifelong (84%) and injections being painful (80.66%) were the most reported concerns. Insulin injections being embarrassing (41.33%), vision problem (42.66%) and fear of weight gain (44.66%) were the least reported concerns of the patients.

Conclusion: A number of important psychological barriers leading to refusal of early insulin initiation in uncontrolled type 2 diabetic patients were found in this study. Requirement of healthcare personnel to inject insulin was found to be the most frequent psychological barrier followed by fear of injection, fear of hypoglycemia, lifelong insulin therapy and injections being painful.