Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 8, 113

Barriers Towards Insulin Therapy in Type 2 Diabetic Patients: Results of an Observational Longitudinal Study

Affiliations

Barriers Towards Insulin Therapy in Type 2 Diabetic Patients: Results of an Observational Longitudinal Study

Norbert Hermanns et al. Health Qual Life Outcomes.

Abstract

Background: The course of barriers towards insulin therapy was analysed in three different groups of type 2 diabetic patients. This observational longitudinal study surveyed a three-month follow-up.

Methods: Participants in this study totalled 130 type 2 diabetic patients. The first subgroup was on insulin therapy at baseline (group 1: n = 57, age 55.6 ± 8.7 yrs, disease duration 12.7 ± 7.2 yrs, HbA1c 8.5 ± 1.6%) and remained on insulin at follow-up. Of an initial 73 insulin-naïve patients, 44 were switched to insulin therapy (group 2: age 58.1 ± 6.8 yrs, disease duration 7.7 ± 5.0 yrs, HbA1c 9.1 ± 1.7%) and 29 patients remained on an oral regimen (group 3: age 52.7 ± 10.7 yrs, disease duration 5.3 ± 4.6 yrs, HbA1c 8.3 ± 1.4%). Barriers towards insulin therapy were measured using the Insulin Treatment Appraisal Scale (ITAS). As generic instruments of health related quality of life patients completed also the Problem Areas of Diabetes Questionnaire (PAID), the WHO-5 Well-Being Scale (WHO-5), the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Trait Version of the State Trait Anxiety Inventory (STAI) at baseline and at three-month follow-up.

Results: At the three-month follow-up, HbA1c had improved in all three groups (7.7 ± 1.2% vs. 7.1 ± 1.1% vs. 6.7 ± 0.8%). The course of negative appraisal of insulin therapy was significantly different in the three groups (p > .003): the ITAS score increased in patients remained on oral antidiabetic drugs (51.2 ± 12.2 to 53.6 ± 12.3), whereas it decreased in patients switched to insulin therapy (49.2 ± 9.8 to 46.2 ± 9.9) or remained on insulin treatment (45.8 ± 8.3 to 44.5 ± 8.0). Diabetes-related distress, trait anxiety, and well-being, showed a similar course in all three groups. The depression score improved significantly in patients switched to insulin treatment compared with patients remaining on insulin therapy.

Conclusions: In summary, this study suggests that a negative appraisal of insulin treatment is modifiable by the initiation of insulin therapy. This finding indicates that barriers to insulin are a rather temporary than a stable phenomenon.

Similar articles

See all similar articles

Cited by 13 articles

See all "Cited by" articles

References

    1. Kulzer B, Hermanns N, Scholze A, Kubiak T, Haak T. Concerns about insulin therapy in patients with type 2 diabetes (Abstract) Diabetes. 2004;53:A438–A439.
    1. Snoek FJ, Skovlund SE, Pouwer F. Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes. Health Qual Life Outcomes. 2007;5:69. doi: 10.1186/1477-7525-5-69. - DOI - PMC - PubMed
    1. Polonsky WH, Fisher L, Guzman S, Villa-Caballero L, Edelman SV. Psychological insulin resistance in patients with type 2 diabetes: the scope of the problem. Diabetes Care. 2005;28:2543–2545. doi: 10.2337/diacare.28.10.2543. - DOI - PubMed
    1. Peyrot M, Rubin RR, Lauritzen T, Skovlund SE, Snoek FJ, Matthews DR, Landgraf R, Kleinebreil L. Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study. Diabetes Care. 2005;28:2673–2679. doi: 10.2337/diacare.28.11.2673. - DOI - PubMed
    1. Petrak F, Stridde E, Leverkus F, Crispin AA, Forst T, Pfutzner A. Development and validation of a new measure to evaluate psychological resistance to insulin treatment. Diabetes Care. 2007;30:2199–2204. doi: 10.2337/dc06-2042. - DOI - PubMed

Publication types

Feedback