Weight change in intensive insulin therapy for type 2 diabetes mellitus as a function of glycosylated hemoglobin (A1C) level achieved: The deep south diabetes program

Duane, Josann; Conway, William

doi:10.1016/s1557-0843(08)80050-4

Cited by 1 publication

(1 citation statement)

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“…Overall, patient experiences with insulin were significantly more positive than their expectations about initiating therapy, with the exception of two items: the expectation and experience of undesirable weight gain with insulin therapy, and whether the insulin delivery system would be noticeable to others. It is well recognised that patients with type 2 diabetes tend to gain weight when using insulin ( 15 ), with 16-week average gains of 0.5–6 kg for injectable ( 30 – 32 ) and 2.7 kg for inhaled ( 33 ) insulin. Patients in this study tended not to have any preconceived expectation about gaining weight after treatment initiation, nor did they perceive their weight gain with insulin therapy to be undesirable, even though the average change in weight was 2 kg during the study period ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Expectations about and experiences with insulin therapy contribute to diabetes treatment satisfaction in insulin-naïve patients with type 2 diabetes

Naegeli¹,

Hayes²

2010

International Journal of Clinical Practice

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Aim:The aim of this study was to investigate how patients’ expectations about and experiences with insulin therapy contribute to diabetes treatment satisfaction.Methods:The Expectations about Insulin Therapy (EAITQ) and the Experience with Insulin Therapy Questionnaires (EWITQ) were administered at baseline and end-point, respectively to insulin-naïve patients with type 2 diabetes in a randomised trial comparing treatment algorithms for inhaled insulin. Pearson correlation coefficients were calculated between EAITQ and EWITQ scores, patient characteristics and patient-reported outcomes measures. Wilcoxon Signed Rank test compared EAITQ and EWITQ item score distributions. Differences between EAITQ and EWITQ scores were calculated to categorise patients according to the extent to which their expectations were met by experiences (i.e. unmet, met, exceeded).Results:EAITQ and EWITQ data were available for 240 patients (61% male, mean age 58 years, mean diabetes duration 10 years, mean baseline HbA1c 8.4%). Increasingly positive expectations were significantly associated with greater self-efficacy; greater levels of positive experiences were significantly associated with greater positive expectations, shorter diabetes duration, less symptom distress, greater well-being, self-efficacy and diabetes treatment satisfaction. Overall, patients’ experiences with inhaled insulin therapy were significantly more positive than their expectations: 58% patients’ experiences exceeded expectations, 29% patients’ experiences met expectations and 13% patients’ experiences did not meet expectations. Post hoc tests indicated that treatment satisfaction scores differed among these groups (all p < 0.01).Conclusion:Expectations may not independently impact treatment satisfaction, but the relationship with experiences significantly contributes to it. The EAITQ and EWITQ may be useful tools for clinicians to better understand patients’ expectations about and experiences with insulin therapy.

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