Patients’ perceptions of injecting insulin and self‐monitoring of blood glucose in the presence of others

Abstract

The aim of this study was to determine if patients with insulin treated diabetes report problems with injecting insulin and self-monitoring of blood glucose (SMBG) in front of others and, if so, explore reasons for the problem.Seventy-six randomly selected patients completed a questionnaire. Statements were presented as 'Are you comfortable with injecting insulin/doing a blood glucose test in front of partner/own children/family/friends/work colleagues or in a public place?', and scored as: almost always/most of the time/sometimes/almost never.Forty-nine participants reported problems with injecting insulin and performing SMBG in the presence of others. Their characteristics were: 25 male and 24 female, 29 type 1 and 20 types 2 diabetes, age range 26-77 years (mean 50.8±12.9 years), duration of diabetes range 1-50 years (mean 19.6±12.8 years), and HbA1c range 6.0-11.5% (mean 8.14±1.25%). Just over a third of respondents 'almost never' felt comfortable with performing insulin injections and SMBG in a public place. Fifty percent of respondents 'almost never' inject insulin in front of work colleagues. Most respondents felt comfortable with performing insulin injections and SMBG in front of their partner, children and family.In conclusion, patients across all ages, gender, diabetes type and diabetes duration report problems with injecting insulin and performing SMBG in front of others. The most common reason cited was 'worried about upsetting or offending others'. Other reasons were 'worried about what others may think of you', and 'do not want others to know that you have diabetes'. A public awareness campaign may help overcome some of these barriers. Copyright

Perceptions of insulin use in type 2 diabetes in primary care: a thematic synthesis

“… T1DM ( n = 64) Non-insulin T2DM ( n = 76) Insulin T2DM ( n = 160) Recruited from online panels and by HCPs Online and face-to-face surveys Leiter [ 57 ] 2005 Canada T1DM & Insulin T2DM Patients only To assess impact of mild, moderate and severe hypoglycaemia and fear of future episodes on patients with T1DM or insulin-treated T2DM Adults with insulin treated T2DM ( n = 335) T1DM ( n = 202) insulin T2DM ( n = 133) Diabetes Clinics Self-administered questionnaire Leiter [ 58 ] 2014 Canada Insulin T2DM Patients and HCPs To assess the frequency and impact of dosing irregularities and self-treated hypoglycaemia in T2DM patients treated with insulin analogues in the GAPP2 study. Patients with Insulin treated T2DM ( n = 156) Physicians (n = 202) Of which: PCPs ( n = 160) Specialists ( n = 42) Online panels and HCP registers Online survey Mehmet [ 59 ] 2015 UK T1DM & Insulin T2DM Patients only To determine if patients report problems with injecting insulin/SMBG in front of others and explore reasons why. Insulin T2DM ( n = 27) T1DM ( n = 49) Hospital Clinic Self-completed questionnaire Mitchell [ 60 ] 2013 UK Insulin T2DM & Non-insulin T2DM Patients only To characterize hypoglycaemic events in T2DM and assess the relationship between the experiences and health outcomes.…”

“…Social factors included stigma, family and friends, economics, work and social activities. Perceived stigma relating to injecting in public was associated with insulin adherence [ 36 , 39 , 41 – 43 , 59 ]. For some this stigma was reflected in the belief that others perceived injecting insulin as being associated with drug addiction [ 36 , 41 , 42 ].…”

“…Of the T2DM patients ( n = 27) in Mehmet et al’s survey [ 59 ] the majority ( n = 20) also experienced problems injecting in public, the main reason being worry about upsetting or offending others.…”

Facilitators and barriers to self-monitoring of blood glucose (SMBG) in diabetic patients visiting family medicine clinics at Akuh. 

“…Some expressed concern that they wanted to learn more about how to self-manage their disease, but it was hard for them to nd the information (20). A systematic review of 20 studies revealed that patients wanted to know more about diabetes, knowledge and communication with the healthcare provider was a signi cant barrier to receiving and understanding diabetes education (43). The study results are similar to another study conducted in Chennai India on 153 patients which revealed that only 37 (24.1%) patients were aware about the SMBG and have been following self-blood glucose monitoring appropriately (28).…”

Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions

“…36,52 Social concerns are often related to perceived social stigma, which can result in, for example, a reluctance to inject insulin in public or around family members. 37,65 The fear that using basal insulin will interfere with the patient's daily routine is likely to have a negative effect on several aspects of their social life. 15,25,37,46 In the Japanese population of the DAWN trial, avoiding social stigma was cited as an issue by 55% of patients and only 7% of physicians.…”