Prevalence and factors affecting opposition of insulin initiation among type2 DM patients at Ain Shams University hospitals

Abstract

espite the rapid development of new antidiabetic medications, glycemic control is not improving. One of the obstacles to diabetes management is delayed initiation of insulin therapy in poorly controlled type 2 DM patients. The current study aimed to measure the prevalence of insulin opposition among Egyptian T2DM patients, uncontrolled on two or more oral hypoglycaemic combination therapy at Ain shams university hospitals .Another aim was to assess factors associated with insulin opposition. A cross sectional study was conducted in outpatient clinics at Ain Shams University hospitals using a purposive sample of 103 T2DM patients with poor glycemic control. A semi-structured interview questionnaire was performed. About half (55.3 %) of the study sample oppsed insulin initiation in spite of poor glycemic control. Comparing opposer and acceptor groups, the negatively stated items that differed significantly between the 2 groups respectively were concern about insulin being a lifelong therapy (84.2% vs 43.5%), delaying insulin as last resort (77.2% vs. 50%), insulin as sign of diabetes severity (75.4% vs. 63 %), feelings of personal failure in self-management (71.9 %vs. 63%), less flexible life (59.6 %vs. 52.2%), time & effort with daily injections (29.8% vs. 13 %) and expected harm from insulin (28.1% vs.13 %).