Adherence to insulin treatment in insulin-naïve type 2 diabetic patients initiated on different insulin regimens

Abstract

ObjectiveWe aimed to evaluate adherence to insulin treatment in terms of treatment persistence and daily adherence to insulin injections among insulin-naïve type 2 diabetic patients initiating insulin therapy with basal (long acting), basal-bolus, and premixed insulin regimens in a tertiary endocrinology outpatient clinic.MethodsA total of 433 (mean age of 55.5±13.0 years; 52.4% females) insulin-naïve type 2 diabetic patients initiated on insulin therapy were included in this questionnaire-based phone interview survey at the sixth month of therapy. Via the telephone interview questions, patients were required to provide information about persistence to insulin treatment, self-reported blood glucose values, and side effects; data on demographics and diabetes characteristics were obtained from medical records.ResultsSelf-reported treatment withdrawal occurred in 20.1% patients, while 20.3% patients were nonadherent to daily insulin. Negative beliefs about insulin therapy (24.1%) and forgetting injections (40.9%) were the most common reasons for treatment withdrawal and dose skipping, respectively. Younger age (49.5±15.0 vs 56.4±12.0 years) (P=0.001) and shorter duration of diabetes (4.8±4.3 vs 8.8±6.3 years) (P=0.0008) and treatment duration (5.2±2.4 vs 10.7±2.4 months) (P=0.0001) were noted, respectively, in discontinuers vs continuers. Basal bolus was the most commonly prescribed insulin regimen (51.0%), while associated with higher likelihood of skipping a dose than regular use (61.3% vs. 46.0%, P=0.04).ConclusionsPersistence to insulin therapy was poorer than anticipated but appeared to be higher in patients with the basal bolus regimen. Negative perceptions about insulin therapy seemed to be the main cause for poor adherence in our cohort.

Level of insulin adherence among diabetes mellitus patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia, 2017: a cross-sectional study

“…This finding is greater than results found in Sudan (45.6%) [15] Turkey (55.7%) [16]. However it is lower than the study done in Addis Ababa 66.8% [17].…”

HbA1c response after insulin initiation in patients with type 2 diabetes mellitus in real life practice: Identifying distinct subgroups

“…These findings are supported by other studies showing that patients at younger ages have poorer glycaemic control . One of the causes for this could be that younger patients may have a more irregular lifestyle and consequently more problems in adhering to treatment with insulin . The higher prevalence of patients treated with sulfonylureas in this group may be an indicator of more severe illnesses.…”

“…16,17 One of the causes for this could be that younger patients may have a more irregular lifestyle and consequently more problems in adhering to treatment with insulin. 18,19 The higher prevalence of patients treated with sulfonylureas in this group may be an indicator of more severe illnesses. During the follow-up period, the poor responders were treated with more intensive regimens including sulfonylureas and metformin.…”

Predictor of the Negative Perception of Insulin Treatment in Type 2 Diabetes Mellitus Individuals

“…13 Türkiye'de yapılan bir araştırmada, insülin kullanan hastaların daha sık hipoglisemi deneyimlemekte olduğu ve diyabetli bireylerin Batı ülkeleri ile kıyasla insülin tedavisine uyumunun kötü olduğu bildirilmiştir. 25 İnsülin kullanan hastaların diyabet tedavi yönetimi ve daha az hipoglisemi yaşamak için daha çok tıbbi beslenme tedavisine uyum sağlaması gerekmektedir. Bu noktada aile desteği önemlidir.…”