Adherence to insulin therapy and associated factors among type 1 and type 2 diabetic patients on follow up in Madda Walabu University Goba Referral Hospital, South East Ethiopia

Abstract

Background Non-adherence to insulin therapy is a major global public health issue that has a causal relationship with increased diabetic complications that leads to further increase in the health care cost. However, adherence to insulin therapy and associated factors among diabetic mellitus (DM) patients are still not studied adequately in Ethiopia. Objective To assess the adherence to insulin therapy and associated factors among type 1 and type 2 diabetic patients on follow-up at Madda Walabu University—Goba Referral Hospital, South East Ethiopia. Method An institution-based, cross-sectional study was employed among 311 both type 1 and type 2 diabetic patients, Madda Walabu University—Goba Referral Hospital from March 4 to April 30, 2020. Study participants were recruited with simple random sampling method. Adherence to insulin therapy was measured by 8-item Morisky medication adherence scale. Therefore from these 8-items, those who score 6 or more are considered as adherent to insulin therapy. The data were collected through interviewer administered questionnaires by trained graduating class nurse students. The data were entered to Epidata version 3.1, and analyzed with SPSS version 25. Bivariate and multivariable logistic regression analyses were used to identify factors associated with adherence to insulin therapy. Statistical significance were declared at p <0.05. Result A total of 311 patients participate in the study with response rate of 100%. Among these only 38.9% of them were adherent to insulin therapy with a CI of [33.5, 44.3]. Having glucometer (AOR = 3.88; 95% CI [1.46, 10.35]), regular hospital follow-up (AOR = 3.13; 95% CI [1.12, 8.70]), being knowledgeable (AOR = 3.36; 95% CI [1.53, 7.37]), and favorable attitudes (AOR = 4.55; 95%CI [1.68, 12.34]) were the factor associated with adherence to insulin therapy. Conclusion This study concluded that adherence to insulin therapy was low in the study area. Having glucometer, regular hospital follow-up, being knowledgeable, and favorable attitudes were the factor associated with adherence to insulin therapy. Attention should be paid to help diabetic patients on acquiring knowledge regarding the need of consistent adherence to insulin therapy and its complications.

Evaluation of Insulin Prescribing Patterns and Associated Burden among Ambulatory Diabetic Patients in Islamabad/Rawalpindi

“…For instance, studies have shown usage rates of 85.6% in various countries, underscoring the preference for pens due to their ease of use and less painful injections (23). Despite the availability of advanced devices, the reliance on syringes remains high in this study, which may reflect local availability, cost considerations, or lack of patient and provider awareness about alternative options (18). Interestingly, the study noted that a significant proportion of participants (66.3%) used oral anti-diabetic medication alongside insulin, highlighting the dual approach in managing type 2 diabetes.…”

Insulin treatment adherence in type 2 diabetes mellitus patients: Literature review

“…A study by Chefik et al, (2022) found that respondents who had a more positive attitude towards insulin therapy had up to 4.55 times greater adherence to insulin therapy than respondents who had a less positive attitude [7]. The study also found that the adherence rate to insulin therapy was 121 (38.9%), mainly due to a diabetes diagnosis period of more than 15 years, poor attitude towards insulin therapy, and suffering from type 2 diabetes, in addition, the absence of a home blood glucose measuring device and poor physical condition, knowledge of insulin therapy, adherence to regular visits to the hospital, and taking two types of drugs.…”

“…On the other hand, diabetic patients who are not adherent to insulin therapy may lose control of blood sugar levels more often than patients who are adherent [6]. To provide efficient treatment, minimize complications from other diseases, and improve the quality of life of diabetic patients to maintain a stable condition, it is important to identify patients who do not adhere to the prescribed regimen [7]. Improving adherence to optimize treatment outcomes can help individuals with diabetes mellitus avoid problems [8].…”