Youngshin Song1, Bon Jeong Ku2, Jeonghwa Cho3, Younghee Jun4, Bohyun Kim1, Soohyun Nam5. 1. Chungnam National University College of Nursing, Daejeon, Republic of Korea. 2. Chungnam National University College of Medicine, Daejeon, Republic of Korea. 3. Daejeon Institute of Science and Technology Department of Nursing, Daejeon, Republic of Korea. 4. Wonkwang Health Science University Department of Nursing, Wonkwang, Republic of Korea. 5. Yale University, School of Nursing, West Haven, CT, USA.
Abstract
BACKGROUND: This study investigated the prevalence of insulin refusal and compared the level of psychological insulin resistance (PIR) with the intention to accept insulin therapy among Korean patients with type 2 diabetes. METHODS: Type 2 diabetes patients (n=1,209) were recruited from inner city outpatient diabetes clinics in 2016. Patient demographic, insulin recommendation, diabetes treatment type, intention to receive insulin therapy, and PIR information was collected using self-reports. The patients were divided into three groups: those who refused insulin therapy (n=184), those who accepted insulin therapy (n=331), and those not recommended for insulin therapy (n=694). Descriptive statistics were used to calculate the prevalence of insulin refusal; t-tests and analyses of variance were used to compare demographics with PIR. RESULTS: The insulin refusal rate was 35.7%. The duration of diabetes, numbers of diabetes-related complications, and glycated hemoglobin levels were significantly lower in the group not recommended for insulin therapy than refused and accepted insulin groups. The level of PIR in insulin refusal group was significantly lower among patients agreeing to receive insulin therapy within 3 months than among those refusing insulin therapy. CONCLUSIONS: The prevalence of insulin refusal in Korea is not low, and people who refuse insulin therapy have high levels of PIR. Strategies to reduce PIR levels are needed. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: This study investigated the prevalence of insulin refusal and compared the level of psychological insulin resistance (PIR) with the intention to accept insulin therapy among Korean patients with type 2 diabetes. METHODS: Type 2 diabetes patients (n=1,209) were recruited from inner city outpatient diabetes clinics in 2016. Patient demographic, insulin recommendation, diabetes treatment type, intention to receive insulin therapy, and PIR information was collected using self-reports. The patients were divided into three groups: those who refused insulin therapy (n=184), those who accepted insulin therapy (n=331), and those not recommended for insulin therapy (n=694). Descriptive statistics were used to calculate the prevalence of insulin refusal; t-tests and analyses of variance were used to compare demographics with PIR. RESULTS: The insulin refusal rate was 35.7%. The duration of diabetes, numbers of diabetes-related complications, and glycated hemoglobin levels were significantly lower in the group not recommended for insulin therapy than refused and accepted insulin groups. The level of PIR in insulin refusal group was significantly lower among patients agreeing to receive insulin therapy within 3 months than among those refusing insulin therapy. CONCLUSIONS: The prevalence of insulin refusal in Korea is not low, and people who refuse insulin therapy have high levels of PIR. Strategies to reduce PIR levels are needed. 2019 Annals of Translational Medicine. All rights reserved.
Authors: William H Polonsky; Lawrence Fisher; Susan Guzman; Leonel Villa-Caballero; Steven V Edelman Journal: Diabetes Care Date: 2005-10 Impact factor: 19.112