Perceptions of insulin therapy amongst Asian patients with diabetes in Singapore

Abstract

Insulin refusal is an important problem amongst our patients with Type 2 diabetes mellitus. Findings of this study suggest that interventions aimed at increasing insulin therapy use should focus on injection-related concerns, perceived lifestyle adaptations and correction of misconceptions. Different interventions may also be required for patients of different educational groups.

Insulin therapy refusal among type II diabetes mellitus patients in Kubang Pasu district, Kedah, Malaysia

“…(4) In a study conducted by Wong et al in Singapore, 70.6% of the patients expressed unwillingness to use insulin therapy. (5) A study conducted on Bangladeshi patients in East London who had poorly controlled T2DM showed that 42.5% refused insulin therapy when it was first prescribed.…”

“…Most of the previous studies from Malaysia and Singapore involved patient populations that consisted of well-urbanised city dwellers. (4,5) …”

Validity and reliability of the Chinese version of the Insulin Treatment Appraisal Scale among primary care patients in Hong Kong

“…14 Previous studies conducted in western countries have identified several factors that can lead to PIR. [11][12][13] These reasons might differ in Asian countries, however. 15,16 Recently, a local primary care research group developed a scale, Chinese Attitudes to Starting Insulin questionnaire, to identify barriers to insulin initiation in insulin-naïve patients with DM.…”

“…10 Their reluctance to initiate insulin use [10][11][12] and its subsequent titration 13 is known as 'psychological insulin resistance' (PIR). The prevalence of PIR has been estimated to be higher in Singapore (70.6%) 11 than in western countries (approximately 20%-40%). 12 A HK survey of 97 participants found a similarly high prevalence of PIR (72.1%).…”

“…11,14 More than 50% of patients were willing to consider or accept insulin if suggested by their primary doctor. This finding might be because of differences in the patient cohorts or the improvements made to the PIR over the years due to patient education.…”