Measuring Psychological Insulin Resistance

Larkin, Mary E.; Capasso, Virginia; Chen, Chien‐Lin; Mahoney, Ellen; Hazard, Barbara P.; Cagliero, Enrico; Nathan, David M.

doi:10.1177/0145721708317869

Cited by 158 publications

(196 citation statements)

References 11 publications

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“…It has also been found that patients may not be aware of the fact that diabetes may not always be managed with exercise, diet, or oral-antidiabetics Larkin et al, 2008). In this regard, the figures observed in our study were much higher than those previously reported.…”

Section: Discussioncontrasting

confidence: 82%

“…For instance, 44.8% and 61% of the patients were reported to hold these type of beliefs in the studies by Polonsky et Previous reports have suggested that social stigmatization represents an important cause of psychogenic resistance toward initiation of insulin therapy, and patients were reluctant to perform insulin injections when accompanied by others. For instance, in a study involving diabetic patients 25% of the individuals reported that they were embarrassed from insulin injections, and 45% believed that others would consider them as "sick" if they performed injections (Larkin et al, 2008). In our study, 80% of the subjects believed that others would label them as "sick", and 30% reported embarrassment with insulin injections.…”

Section: Discussionmentioning

confidence: 40%

“…According to Larkin et al's study, 37% of the patients expected that the injection would cause pain, and 40% reported that they were afraid that they could not administer the injections (Larkin et al, 2008 Used Mann-Whitney U test. *p<0.05 **p<0.01 r: Spearman's rho correlation coefficient used Mann-Whitney U test.…”

Section: Discussionmentioning

confidence: 99%

“…(Polonsky & Jackson, 2004) and Larkin et al (Larkin et al, 2008), respectively. Again the figure observed in the current study, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Patients in other studies were also reported to think that insulin use could lead to other problems, a major one of which is hypoglycemia (Diabetes Attitudes, Wishes and Needs, 2002;Korytkowski, 2002;Larkin et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

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Identification of perceptions and thoughts that can create psychological resistance to insulin use in type 2 diabetes mellitus patients

Kırlı¹,

Berkol²,

Yumrukçal³

et al. 2017

JNBS

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 40%

Section: Discussionmentioning

confidence: 99%

“…(Polonsky & Jackson, 2004) and Larkin et al (Larkin et al, 2008), respectively. Again the figure observed in the current study, i.e.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Identification of perceptions and thoughts that can create psychological resistance to insulin use in type 2 diabetes mellitus patients

Kırlı¹,

Berkol²,

Yumrukçal³

et al. 2017

JNBS

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Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use

et al. 2017

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Background: Hypoglycemia inpatient admissions are costly and potentially preventable. Using established risk factors for hypoglycemia, we set out to develop a risk-scoring tool using the data from an Asian population. Methods:In this historical cohort study, we extracted the data of 47,404 type 2 diabetes mellitus (T2DM) patients with complete data based on their last visit in 2012 at selected National Healthcare Group Polyclinics in Singapore. The outcome variable is the occurrence of any hypoglycemia inpatient admission within 6 months from their last visit in 2012. We entered the following potential predictors into a logistic regression model: 1) Age; 2) Largest reduction in glycated hemoglobin within 1 year; 3) Last body mass index; 4) Last estimated glomerular filtration rate; 5) Usage of sulphonylurea and/or insulin; 6) Last glycated hemoglobin; 7) Any previous hypoglycemia inpatient admission in the past 1 year. The relative weightage of predictors were compared, and the model parameters were subsequently converted to a simple risk score (range: 0 to 100). Results:We found predictors 1 to 5 to be statistically significant for subsequent hypoglycemia inpatient admission. In our study population, based on a sensitivity of 73.8% and a specificity of 73.1%, a cutoff score of 38 was selected. The area under the receiver-operating characteristic curve was 0.809 (CI: 0.763 -0.855). Conclusions:A risk score using commonly available clinical data can help to identify those at risk of hypoglycemia inpatient admission with satisfactory level of accuracy. This score needs to be further validated with randomized controlled studies.

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Afrezza: An inhaled approach to insulin delivery

Fleming

Davis

2015

Journal of the American Association of Nurse Practitioners

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Purpose The purpose of this article is to educate nurse practitioners about Afrezza. Data sources A comprehensive literature search was conducted using MEDLINE for clinical trial data. Information from the Centers of Disease Control and Prevention, World Health Organization, clinical guidelines, Food and Drug Administration labeling, briefings, and press releases was also utilized. Conclusions Afrezza represents a promising noninjectable insulin delivery option for type 1 and type 2 diabetes mellitus. According to clinical trial evidence, it appears to be efficacious and comparable to currently available prandial insulin options, and based on current data, it appears to be a safe alternative to injectable insulin with high treatment satisfaction. Implications for practice Afrezza may offer an alternative for insulin naïve patients who are hesitant about initiating traditional insulin. It may cause less weight gain when compared to subcutaneous mealtime insulin with a more rapid absorption and elimination profile, but more long‐term studies are needed. Afrezza is limited in type 1 diabetes to use in combination with basal insulin. It is not recommended in the treatment of diabetic ketoacidosis or for patients who smoke. It is contraindicated during hypoglycemic episodes, in chronic lung diseases, or in those with hypersensitivity to regular human insulin or any of the excipients in Afrezza.

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Measuring Psychological Insulin Resistance

Abstract: The results of the surveys, which were generally consistent, identified several remediable misconceptions regarding insulin therapy and suggest targets for educational interventions.

Cited by 158 publications

References 11 publications

Identification of perceptions and thoughts that can create psychological resistance to insulin use in type 2 diabetes mellitus patients

Identification of perceptions and thoughts that can create psychological resistance to insulin use in type 2 diabetes mellitus patients

Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use

Afrezza: An inhaled approach to insulin delivery

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