Psychological insulin resistance and its impact on self-management in type II diabetes mellitus patients treated with insulin therapy.

Publisher: Wiley Country of Publication: Australia NLM ID: 9613615 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1440-172X (Electronic) Linking ISSN: 13227114 NLM ISO Abbreviation: Int J Nurs Pract

Original Publication: Carlton, Vic., Australia : Wiley, c1995-

Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/complications ; Insulin Resistance* ; Self-Management*; Humans ; Insulin/therapeutic use ; Hypoglycemic Agents ; Cross-Sectional Studies

Aims: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self-management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self-management in patients with type II diabetes mellitus treated with insulin therapy.
Methods: We adopted a cross-sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self-management using the barriers to insulin treatment questionnaire and the partners in health scale.
Results: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self-management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin-related outcomes, no diabetes-related complications, less fear of injection and self-testing, no hypoglycaemia within the previous year, and younger age.
Conclusion: Insulin therapy injection by patient and no diabetes-related complications were the most common factors associated with overall self-management and with each domain of self-management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self-management.
(© 2023 John Wiley & Sons Australia, Ltd.)

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1-CMUBHR108-007 China Medical University Hospital; China Medical University Beigang Hospital Research Program in Taiwan

Keywords: diabetes complications; hypoglycaemia; insulin; psychological insulin resistance; self‐management; type II diabetes mellitus

0 (Insulin)
0 (Hypoglycemic Agents)

Date Created: 20230819 Date Completed: 20240409 Latest Revision: 20240409

20240409

10.1111/ijn.13190

37596927